Individual provider Active NPI

Brad Christensen, D.C.

  • Chiropractor
  • St Charles, IL
National Provider Identifier
1699957563
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-011158 Issued in IL
Practice address
302 S 14TH St
St Charles, IL 60174-2511
Phone
(630) 584-5800
Fax
(630) 584-6190
NPI assigned
Dec 3, 2007
Last updated
Sep 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3708012 WI
Chiropractor 111N00000X 038-011158 IL Primary

Addresses

Primary practice location

302 S 14TH St
St Charles, IL 60174-2511

Mailing address

129 Commercial Dr 5a
Yorkville, IL 60560-4731
Phone (630) 553-7737

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080201000318 WI Practitioner - Chiropractic 9830271634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Geneva Chiropractic PartnersGroup PAC ID 6305731506, 2 clinicians

Practice addresses (Care Compare)

612 S Wells St
Suite C
Lake Geneva, WI 53147-2159
Phone (262) 248-8177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-011158ILMDChiropractor
3708012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Geneva Chiropractic Partners Chiropractor CurrentSince Mar 20, 2017 Accepting new patients
F G Obregon & Associates SC Chiropractor Past Accepting new patients
Chiro One Wellness Center of West Chicago LLC Chiropractor Past Accepting new patients
Eliesha R Evans DC SC Chiropractor Past Accepting new patients
St. Charles Pain and Wellness Center, LLC Chiropractor PastSince Jun 8, 2010 Accepting new patients
Fox Valley Physician Services SC Chiropractor Past Accepting new patients
Stafford Chiropractic Chiropractor Past Accepting new patients
Nyuli Chiropractic, P.C. Chiropractor Past Accepting new patients

Locations

612 S Wells St
Ste C
Lake Geneva, WI 53147
Phone (262) 248-8177

Organizations & group practices 8

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1699957563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 COMMERCIAL DR 5A",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605604731",
            "telephone_number": "630-553-7737",
            "fax_number": "630-553-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S 14TH ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742511",
            "telephone_number": "630-584-5800",
            "fax_number": "630-584-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "BRAD",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3708012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-011158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.