Organization Active NPI

Martin J. Labuda, DC, PC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1720280779
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009597 Issued in IL
Legal business name
MARTIN J. LABUDA, DC, PC
Practice address
3832 N Broadway St
Chicago, IL 60613-3218
Phone
(773) 296-2225
Fax
(773) 296-0731
NPI assigned
Jun 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Authorized official

Name
Dr. Martin John Labuda Jr., DCNPI 1841316973
Title
President
Phone
(773) 296-2225

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038-009597 IL Primary

Addresses

Primary practice location

3832 N Broadway St
Chicago, IL 60613-3218

Mailing address

3832 N Broadway St
Chicago, IL 60613-3218
Phone (773) 296-2225

Other identifiers 3

IdentifierTypeStateIssuer
4063763OtherILCIGNA
01632439OtherILBLUE CROSS BLUE SHIELD
IL7546OtherILMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121012000517 IL Part B Supplier - Clinic/Group Practice 6305095043 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1720280779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3832 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133218",
            "telephone_number": "773-296-2225",
            "fax_number": "773-296-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3832 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133218",
            "telephone_number": "773-296-2225",
            "fax_number": "773-296-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN J. LABUDA, DC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "LABUDA",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-296-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4063763",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01632439",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL7546",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.