Organization Active NPI

Harrison Chiropractic Center, S.C.

  • Chiropractor
  • McHenry, IL
National Provider Identifier
1790092153
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011740 Issued in IL
Legal business name
HARRISON CHIROPRACTIC CENTER, S.C.
Practice address
3643 Municipal Dr
McHenry, IL 60050-5434
Phone
(815) 759-1100
Fax
(815) 344-1208
NPI assigned
Sep 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Dr. Andrew Michael Harrison, D.C.NPI 1902805310
Title
Business Owner
Phone
(815) 759-1100

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 038.011740 IL Primary

Addresses

Primary practice location

3643 Municipal Dr
McHenry, IL 60050-5434

Mailing address

3643 Municipal Dr
McHenry, IL 60050-5434
Phone (815) 759-1100

Other identifiers 1

IdentifierTypeStateIssuer
F400154860OtherILMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110117000201 IL Part B Supplier - Clinic/Group Practice 9234328618 Receives reassigned benefits from 1 practitioner
Practice locations: McHenry, IL

National Provider Directory

National Provider Directory

Locations

4005 W Kane Ave
Ste L
McHenry, IL 60050
Phone (815) 759-1100

3643 Municipal Dr
McHenry, IL 60050
Phone (815) 344-1025

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": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1790092153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 MUNICIPAL DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505434",
            "telephone_number": "815-759-1100",
            "fax_number": "815-344-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 MUNICIPAL DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505434",
            "telephone_number": "815-759-1100",
            "fax_number": "815-344-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON CHIROPRACTIC CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "815-759-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400154860",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.