Individual provider Active NPI

Nicholas Gene Scanio, D.C.

  • Chiropractor
  • Evanston, IL
National Provider Identifier
1639579667
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012664 Issued in IL
Practice address
1117 Emerson St
Evanston, IL 60201-3131
Phone
(847) 869-1773
NPI assigned
Aug 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012664 IL Primary

Addresses

Primary practice location

1117 Emerson St
Evanston, IL 60201-3131

Mailing address

1117 Emerson St
Evanston, IL 60201-3131
Phone (847) 869-1773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141017000252 IL Practitioner - Chiropractic 4082835962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Wellness Revolution Chiropractic and Acupuncture CenterGroup PAC ID 4981669678, 8 clinicians

Practice addresses (Care Compare)

1117 Emerson St
Evanston, IL 60201-3131
Phone (847) 869-1773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012664ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Revolution Chiropractic & Acupuncture Center Chiropractor CurrentSince Sep 1, 2014 Accepting new patients
Wellness Revolution Lakeview LLC Chiropractor PastSince Sep 1, 2014 Accepting new patients

Locations

1117 Emerson St
Evanston, IL 60201
Phone (847) 869-1773

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1639579667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 EMERSON ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013131",
            "telephone_number": "847-869-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 EMERSON ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013131",
            "telephone_number": "847-869-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANIO",
        "first_name": "NICHOLAS",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.