Joseph John Ethen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.011678 Issued in IL

Practice address

662 Vernon Ave
Glencoe, IL 60022-1694

Phone

(847) 835-4700

Fax

(847) 835-8408

NPI assigned

Mar 23, 2006

Last updated

May 26, 2020By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ethen Chiropractic & Wellness, SC

  dba Lakefront Chiropractic Center

  • Chiropractor
  • Glencoe, IL
  • NPI 1457530628
  Medicare reassignment NPD Authorized official
• Ethen Chiropractic and Wellness

  • Chiropractor
  • Glencoe, IL
  • NPI 1336535608
  NPD (past) Authorized official
• Lakefront Chiropractic

  • Chiropractor
  • Glencoe, IL
  • NPI 1972990737
  NPD (past) Authorized official

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1700845047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 VERNON AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221694",
            "telephone_number": "847-835-4700",
            "fax_number": "847-835-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "662 VERNON AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221694",
            "telephone_number": "847-835-4700",
            "fax_number": "847-835-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHEN",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2638686",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "9358811",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "2867938",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doyle Opticians of Glencoe Inc (Marcus Opticians)
• DRS Sripada MD SC
• Juliette Rachel Ellis, P.T.
• Ethen Chiropractic & Wellness, SC (Lakefront Chiropractic Center)
• Ethen Chiropractic and Wellness
• Family Service of Glencoe
• Fore Fitness and Rehabilitation, Inc
• Jane Ann Forester, D.O.
• Silvia Schneider Fox, PSY.D.
• Matthew Frank

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.