Black Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038003757 Issued in IL

Legal business name

BLACK CHIROPRACTIC PC

Doing business as

Black Chiropractic & Family Wellness Center

Practice address

1609 Sherman Ave
204
Evanston, IL 60201-3753

Phone

(847) 328-2008

Fax

(847) 328-8171

NPI assigned

Feb 25, 2011

Organization subpart

No

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

Authorized official

Name

Constance A Black, D.C.

Title

President

Phone

(847) 328-2008

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Black Chiropractic & Family Wellness Center Doing business as

Locations

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1689971715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 SHERMAN AVE",
            "address_2": "204",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013753",
            "telephone_number": "847-328-2008",
            "fax_number": "847-328-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 SHERMAN AVE",
            "address_2": "204",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013753",
            "telephone_number": "847-328-2008",
            "fax_number": "847-328-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-328-2008",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038003757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "01682433",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Chiropractic & Family Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Marie Bissing, DNP
• Matthew Biszewski, PHARM.D.
• Bites Orthodontics PLLC (EverSmiles Orthodontics)
• Ruth Ann Bittner, MSW
• BK Dental-Evanston LLC
• Constance Ann Black, DC
• Danielle Anna Black, PH.D.
• Jennifer Lynn Black, LCPC, CCMHC, LBS1
• Jonella Renee Black, PT
• Miranda Brooke Blackburn

• Chiropractor in Evanston, IL
• Providers in Evanston, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.