Individual provider Active NPI

Joel John Sammarco, DC

  • Chiropractor
  • Wilmette, IL
National Provider Identifier
1669482469
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
3207 Lake Ave
Suite 5a
Wilmette, IL 60091-1082
Phone
(847) 920-1822
Fax
(847) 920-1823
NPI assigned
Aug 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

3207 Lake Ave
Suite 5a
Wilmette, IL 60091-1082

Mailing address

3207 Lake Ave
Suite 5a
Wilmette, IL 60091-1082
Phone (847) 920-1822

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040106000554 IL Practitioner - Chiropractic 1254230568 Practice locations: Wilmette, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3207 Lake Ave
5A
Wilmette, IL 60091-1070
Phone (847) 920-1822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009958ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L Belba DC PC Chiropractor PastSince Jun 1, 2004 Accepting new patients
Joel J Sammarco, DC, PC Chiropractor Past Accepting new patients

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669482469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 LAKE AVE",
            "address_2": "SUITE 5A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911082",
            "telephone_number": "847-920-1822",
            "fax_number": "847-920-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 LAKE AVE",
            "address_2": "SUITE 5A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911082",
            "telephone_number": "847-920-1822",
            "fax_number": "847-920-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMARCO",
        "first_name": "JOEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.