Individual provider Active NPI

Linda Sue Breitenstein, DC

  • Chiropractor
  • Elmhurst, IL
National Provider Identifier
1790889947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
135 N Addison Ave
Suite 107
Elmhurst, IL 60126
Phone
(630) 530-0506
Fax
(630) 530-0854
NPI assigned
Sep 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

135 N Addison Ave
Suite 107
Elmhurst, IL 60126

Mailing address

135 N Addison Ave
Ste 107
Elmhurst, IL 60126
Phone (630) 530-0506

Other identifiers 2

IdentifierTypeStateIssuer
2232660OtherILBCBS
5761484OtherILCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405000853 IL Practitioner - Chiropractic 9234186941 Practice locations: Villa Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

63 E Park Blvd
Villa Park, IL 60181-2962

63 E Park Boulevard
Villa Park, IL 60181-2962
Phone (630) 617-5589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038010331ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Chiropractic Care, SC Past Accepting new patients

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": "1157760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790889947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N ADDISON AVE",
            "address_2": "STE 107",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "60126",
            "telephone_number": "630-530-0506",
            "fax_number": "630-530-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N ADDISON AVE",
            "address_2": "SUITE 107",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "60126",
            "telephone_number": "630-530-0506",
            "fax_number": "630-530-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITENSTEIN",
        "first_name": "LINDA SUE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2232660",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5761484",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.