Stephen Petrak, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038012618 Issued in IL

Practice address

3444 N Halsted St
Chicago, IL 60657-9492

Phone

(773) 525-9100

Fax

(773) 525-9105

NPI assigned

May 12, 2014

Last updated

May 12, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Petrak Family Chiropractic Center S.C

  • Chiropractor
  • Westchester, IL
  • NPI 1841661774
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1811308919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606579492",
            "telephone_number": "773-525-9100",
            "fax_number": "773-525-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606579492",
            "telephone_number": "773-525-9100",
            "fax_number": "773-525-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAK",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa S Petito
• Alyssa Michelle Petko, O.D.
• Jacqueline Petkovic, RN
• Grace Petr, PA-C
• Leah Kristina Petrak, PA-C
• Alexandra Petrakos, MD
• Paige Avery Petrando, CCC-SLP
• Michael Edward Petravick, MD
• Louis C Petrelli, PT, DPT
• Jessica Petreski, PA-C

• 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 May 12, 2014; 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.