Individual provider Active NPI

Paul Allen Marando, D.C.

  • Sports Physician Chiropractor
  • Chicago, IL
National Provider Identifier
1659402055
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
038009361 Issued in IL
Practice address
1700 W Diversey Pkwy
Suite 2W
Chicago, IL 60614-1010
Phone
(773) 348-0033
Fax
(773) 348-0553
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 038009361 IL Primary

Addresses

Primary practice location

1700 W Diversey Pkwy
Suite 2W
Chicago, IL 60614-1010

Mailing address

1700 W Diversey Pkwy
Suite 2W
Chicago, IL 60614-1010
Phone (773) 348-0033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041203000051 IL Practitioner - Chiropractic 1355307224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Plus North LTDGroup PAC ID 9537125422, 2 clinicians

Practice addresses (Care Compare)

1700 W Diversey Pkwy
Suite 2W
Chicago, IL 60614-6884
Phone (773) 348-0033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038009361ILMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Plus North LTD Sports Physician CurrentSince Dec 1, 2004 Accepting new patients

Locations

1700 W Diversey Pkwy
Chicago, IL 60614
Phone (773) 348-0033

1700 W Diversey Pkwy
Ste 2W
Chicago, IL 60614
Phone (773) 348-0033

Organizations & group practices 1

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1659402055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W DIVERSEY PKWY",
            "address_2": "SUITE 2W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141010",
            "telephone_number": "773-348-0033",
            "fax_number": "773-348-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W DIVERSEY PKWY",
            "address_2": "SUITE 2W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141010",
            "telephone_number": "773-348-0033",
            "fax_number": "773-348-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARANDO",
        "first_name": "PAUL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038009361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.