Individual provider Active NPI

Matthew Thomas Clement, D.C.

  • Chiropractor
  • Evanston, IL
National Provider Identifier
1760852560
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012884 Issued in IL
Practice address
1318 Chicago Ave
Evanston, IL 60201-4725
Phone
(847) 478-4960
NPI assigned
Oct 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012884 IL Primary

Addresses

Primary practice location

1318 Chicago Ave
Evanston, IL 60201-4725

Mailing address

1318 Chicago Ave
Evanston, IL 60201-4725
Phone (847) 478-4960

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191126002605 IL Practitioner - Chiropractic 8527491927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Health and Physical Therapy Center SCGroup PAC ID 3870596455, 6 clinicians

Practice addresses (Care Compare)

5545 W Montrose Ave
Chicago, IL 60641-1331
Phone (773) 282-6648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012884ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Health and Physical Therapy Center SC CurrentSince Oct 24, 2019 Accepting new patients

Locations

5545 W Montrose Ave
Chicago, IL 60641
Phone (773) 282-6648

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1760852560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014725",
            "telephone_number": "847-478-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014725",
            "telephone_number": "847-478-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.