Sargon Benjamin Odisho, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038010338 Issued in IL

Practice address

1360 N Sandburg Ter
Chicago, IL 60610-2075

Phone

(312) 944-4653

Fax

(312) 944-0747

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Heroes Health Care Inc

  • Chiropractor
  • Chicago, IL
  • NPI 1932459393
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1790714061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 DUNHILL DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891515",
            "telephone_number": "312-944-4653",
            "fax_number": "312-944-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 N SANDBURG TER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102075",
            "telephone_number": "312-944-4653",
            "fax_number": "312-944-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODISHO",
        "first_name": "SARGON",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E Odgers, M.D.
• Kate Odgers, PA-C
• Edward Odicho, PHARM.D
• Alksander Spanya Odisho, D.C.
• Ramel Odisho, DMD
• Paul Blair Odland, M.D.
• Samuel Michael Odoi, MD
• Okechi Odoka, APRN, CNP
• Reginald Odom, DDS
• Vicki Odom, RN

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.