Scott Jason Spencer, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

038009369 Issued in IL

Practice address

205 W Randolph St
1205
Chicago, IL 60606-1867

Phone

(312) 265-6908

Fax

(312) 264-0347

NPI assigned

Jan 4, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr Brendan Lee PC

  • Chiropractor
  • Northbrook, IL
  • NPI 1265891030
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1679620306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "1205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-265-6908",
            "fax_number": "312-264-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "1205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-265-6908",
            "fax_number": "312-264-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "SCOTT",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038009369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7626403",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01629928",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Lynn Spencer, LMT
• Mark David Spencer, OD
• Michael Spencer
• Nicole Jeanette Spencer, M.D.
• Sara Marie Spencer, M.S., C.G.C.
• Shemari Ashanti Spencer, LMFT
• Susan Spencer
• Tahkeia Monay Spencer
• Takiyah Spencer
• Vanesia Spencer, PT

• Sports Physician Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Sports Physician Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.