Active NPI
Mark Sirotinskiy, D.C.
- Chiropractor
- Crestwood, IL
National Provider Identifier
1730484783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038-011871
- Practice address
- 13657 Cicero Ave
Crestwood, IL 60445-1936 - Phone
- (708) 396-2500
- Fax
- (708) 396-8605
- NPI assigned
- Jan 24, 2011
- Last updated
- Jan 24, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-011871 | IL | Primary |
Addresses
Primary practice location
13657 Cicero Ave
Crestwood, IL 60445-1936
Mailing address
7711 W 159TH St
Suite 102
Tinley Park, IL 60477-1329
Phone (708) 532-8080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-011871 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acu-Med Integrative Medicine LLC | Current | Accepting new patients | |
| Health on Earth Wellness Centers LLC | Chiropractor | Past | Accepting new patients |
| Crestwood Chiropractic and Rehab | Chiropractor | Past | Accepting new patients |
Locations
1428 E Racine Ave
Waukesha, WI 53186
Phone (262) 269-5107
Organizations & group practices 3
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.
-
dba Acupuncture & Chinese Medical Center
- Acupuncturist
- Waukesha, WI
- NPI 1457781981
-
- Chiropractor
- Crestwood, IL
- NPI 1659461309
-
dba Crestwood Chiropractic and Rehab
- Chiropractor
- Crestwood, IL
- NPI 1629270954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295827200000",
"number": "1730484783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7711 W 159TH ST",
"address_2": "SUITE 102",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771329",
"telephone_number": "708-532-8080",
"fax_number": "708-532-8383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13657 CICERO AVE",
"city": "CRESTWOOD",
"state": "IL",
"postal_code": "604451936",
"telephone_number": "708-396-2500",
"fax_number": "708-396-8605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIROTINSKIY",
"first_name": "MARK",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-24",
"last_updated": "2011-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038-011871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crestwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.