NPIMap

Organization Active NPI

Bartlett Chiropractic Clinic, S.C.

  • Chiropractor
  • Bartlett, IL
National Provider Identifier
1700132891
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010561 Issued in IL
Legal business name
BARTLETT CHIROPRACTIC CLINIC, S.C.
Practice address
138 S Oak Ave
Bartlett, IL 60103-6620
Phone
(630) 830-1500
Fax
(630) 830-2513
NPI assigned
Jul 26, 2012
Last updated
Jul 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Authorized official

Name
Mr. Keith Charles Richard, DCNPI 1245399054
Title
President
Phone
(630) 830-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038010561 IL Primary

Addresses

Primary practice location

138 S Oak Ave
Bartlett, IL 60103-6620

Mailing address

138 S Oak Ave
Bartlett, IL 60103-6620
Phone (630) 830-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121129000584 IL Part B Supplier - Clinic/Group Practice 6406008291 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Round Lake Beach, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bartlett Chiropractic Clinic SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

138 S Oak Ave
Bartlett, IL 60103
Phone (630) 830-1500

314 W Rollins Rd
Ste B
Round Lake Beach, IL 60073
Phone (847) 546-4220

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343260800000",
    "number": "1700132891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S OAK AVE",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601036620",
            "telephone_number": "630-830-1500",
            "fax_number": "630-830-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S OAK AVE",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601036620",
            "telephone_number": "630-830-1500",
            "fax_number": "630-830-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTLETT CHIROPRACTIC CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-830-1500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.