Individual provider Active NPI

Shawn M Breton, DC

  • Internist Chiropractor
  • Mount Prospect, IL
National Provider Identifier
1740273119
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
038.008779 Issued in IL
Practice address
106 S Emerson St
Mount Prospect, IL 60056-3220
Phone
(847) 368-1234
Fax
(847) 603-7478
NPI assigned
Aug 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038008779 IL
Internist Chiropractor 111NI0900X 038.008779 IL Primary

Addresses

Primary practice location

106 S Emerson St
Mount Prospect, IL 60056-3220

Mailing address

106 S Emerson St
Mount Prospect, IL 60056-3220
Phone (847) 368-1234

Other identifiers 1

IdentifierTypeStateIssuer
01635079OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Shawn M Breton Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031111000580 IL Practitioner - Chiropractic 1153234539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

815 E Rand Rd
Arlington Heights, IL 60004-4007
Phone (847) 368-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038008779ILMDChiropractor
038.008779ILMDInternist Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Breton Chiropractic, LTD Internist CurrentSince May 9, 2005 Accepting new patients
Hofmaier Chiropractic LTD Chiropractor Past Accepting new patients
Dynapeak Fitness and Physical Therapy, PC PastSince Apr 14, 2017 Accepting new patients

Locations

815 E Rand Rd
Arlington Hts, IL 60004
Phone (312) 253-2112

106 S Emerson St
Mt Prospect, IL 60056
Phone (847) 368-1234

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1740273119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S EMERSON ST",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563220",
            "telephone_number": "847-368-1234",
            "fax_number": "847-603-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S EMERSON ST",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563220",
            "telephone_number": "847-368-1234",
            "fax_number": "847-603-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETON",
        "first_name": "SHAWN",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008779",
            "primary": false
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "IL",
            "license": "038.008779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01635079",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "BRETON",
            "middle_name": "M",
            "credential": "PC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.