John Nolan Bouma, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

419 Center St
Suite B
Grayslake, IL 60030-1625

Phone

(847) 543-1055

Fax

(847) 543-8648

NPI assigned

Jan 9, 2008

Last updated

Feb 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Premier Chiropractic Center, LTD

  • Chiropractor
  • Grayslake, IL
  • NPI 1336156280
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1649455502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 CENTER ST",
            "address_2": "SUITE B",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301625",
            "telephone_number": "847-543-1055",
            "fax_number": "847-543-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 CENTER ST",
            "address_2": "SUITE B",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301625",
            "telephone_number": "847-543-1055",
            "fax_number": "847-543-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUMA",
        "first_name": "JOHN",
        "middle_name": "NOLAN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4915076",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alla Bodner, M.D.
• Rubi Bolles, LCSW
• Lorna Bolton
• Justin Bond
• Tracy Boraca, RBT 17-42752
• Boyceboys Inc. (ActiKare Responsive In-Home Care)
• Jessica C Boyd
• Amanda Lea Brannon Lynch, MS, CCC-SLP
• Eauly Brautigam, LCPC
• Stephen Brayden, DPT

• Chiropractor in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.