Individual provider Active NPI

Robin Michelle Henderson, DC DICCP

  • Chiropractor
  • Bartlett, IL
National Provider Identifier
1750399408
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009167 Issued in IL
Practice address
366 S Main St
Bartlett, IL 60103-4423
Phone
(630) 837-3707
Fax
(630) 837-3706
NPI assigned
Aug 4, 2006
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038009167 IL Primary

Addresses

Primary practice location

366 S Main St
Bartlett, IL 60103-4423

Mailing address

366 S Main St
Bartlett, IL 60103-4423
Phone (630) 837-3707

Other practice location 1

776 W Bartlett Rd
Bartlett, IL 60103-4482
Phone (630) 837-3707

Other identifiers 1

IdentifierTypeStateIssuer
205031MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070124000128 IL Practitioner - Chiropractic 8527069236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balance Family Chiropractic, LTD.Group PAC ID 5092716704, 2 clinicians

Practice addresses (Care Compare)

366 S Main St
Bartlett, IL 60103-4423
Phone (630) 837-3707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
038009167ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Family Chiropractic, LTD. Chiropractor CurrentSince Jan 19, 2007 Accepting new patients

Locations

366 S Main St
Bartlett, IL 60103
Phone (630) 837-3707

776 W Bartlett Rd
Bartlett, IL 60103
Phone (630) 837-3707

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1750399408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 S MAIN ST",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034423",
            "telephone_number": "630-837-3707",
            "fax_number": "630-837-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 S MAIN ST",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034423",
            "telephone_number": "630-837-3707",
            "fax_number": "630-837-3706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "776 W Bartlett Rd",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "IL",
            "postal_code": "601034482",
            "country_code": "US",
            "telephone_number": "630-837-3707",
            "fax_number": "630-837-3706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ROBIN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DC DICCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205031",
            "state": "IL"
        }
    ],
    "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 Aug 20, 2018; 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.