Bruce Rachum, D.C., Professional Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038 007062 Issued in IL

Legal business name

BRUCE RACHUM, D.C., PROFESSIONAL CORPORATION

Practice address

6430 Cermak Rd
Berwyn, IL 60402-2310

Phone

(708) 749-0100

Fax

(708) 749-7497

NPI assigned

Jun 22, 2010

Last updated

Jun 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Rachum, D.C.NPI 1700943321

Title

Practice Owner

Phone

(708) 749-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce Rachum, D.C.

  • Chiropractor
  • Berwyn, IL
  • NPI 1700943321
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1811218050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022310",
            "telephone_number": "708-749-0100",
            "fax_number": "708-749-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022310",
            "telephone_number": "708-749-0100",
            "fax_number": "708-749-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE RACHUM, D.C., PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "RACHUM",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "708-749-0100",
        "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 007062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038 007062",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marcia Brown, RD
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• Ann Lake Bryant, M.A.
• Richmond Komla Enya Buckner, MD
• Megan Burg
• Jennifer Busker, M.A.
• Esteban Andres Cabezas Rubio, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.