Active NPI
Andrew C Unfried, D.C.
- Chiropractor
- Glen Carbon, IL
National Provider Identifier
1669765483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.011939
- Practice address
- 5 Glen Ed Professional Park
Glen Carbon, IL 62034-3333 - Phone
- (618) 558-2429
- NPI assigned
- May 26, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.011939 | IL | Primary |
Addresses
Primary practice location
5 Glen Ed Professional Park
Glen Carbon, IL 62034-3333
Mailing address
917 Copper Ridge Dr
Maryville, IL 62062-5679
Phone (618) 558-2429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110721000782 | IL | Practitioner - Chiropractic | 4486822285 | Practice locations: Glen Carbon, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5 Glen Ed Professional Park
Glen Carbon, IL 62034-3333
Phone (618) 558-2429
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.011939 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1669765483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 COPPER RIDGE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625679",
"telephone_number": "618-558-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 GLEN ED PROFESSIONAL PARK",
"city": "GLEN CARBON",
"state": "IL",
"postal_code": "620343333",
"telephone_number": "618-558-2429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNFRIED",
"first_name": "ANDREW",
"middle_name": "C",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-26",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.011939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Carbon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.