Individual provider Active NPI

Katie Rose Fortman, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1669129136
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013753 Issued in IL
Practice address
600 W Chicago Ave Ste 1000
Chicago, IL 60654-2801
Phone
(312) 625-0845
NPI assigned
Mar 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013753 IL Primary

Addresses

Primary practice location

600 W Chicago Ave Ste 1000
Chicago, IL 60654-2801

Mailing address

1111 W 14TH PL Unit 109
Chicago, IL 60608-2796
Phone (708) 945-8437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
038013753ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
DKRF Inc Chiropractor CurrentSince Feb 25, 2024 Accepting new patients
Cornerstone Health Company Chiropractor PastSince Mar 1, 2022 Accepting new patients

Locations

308 W Erie St
Ste 100
Chicago, IL 60654
Phone (312) 877-5155

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1669129136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W 14TH PL UNIT 109",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082796",
            "telephone_number": "708-945-8437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W CHICAGO AVE STE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606542801",
            "telephone_number": "312-625-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTMAN",
        "first_name": "KATIE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013753",
            "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 Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.