Active NPI
Kristina L Sargent, DC
- Nutrition Chiropractor
- Wheaton, IL
National Provider Identifier
1811909633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 038007040
- Practice address
- 416 E Roosevelt Rd
Ste 107
Wheaton, IL 60187-5589 - Phone
- (630) 682-5090
- Fax
- (630) 260-1230
- NPI assigned
- Aug 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 038007040 | IL | |
| Nutrition Chiropractor | 111NN1001X | 038007040 | IL | Primary |
Addresses
Primary practice location
416 E Roosevelt Rd
Ste 107
Wheaton, IL 60187-5589
Mailing address
416 E Roosevelt Rd
Ste 107
Wheaton, IL 60187-5589
Phone (630) 682-5090
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02215708 | Other | IL | BCBS |
| 601205300 | Other | IL | FED WORK COMP |
| 271151301 | Other | IL | LBN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038007040 | IL | MD | Internist Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1811909633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 E ROOSEVELT RD",
"address_2": "STE 107",
"city": "WHEATON",
"state": "IL",
"postal_code": "601875589",
"telephone_number": "630-682-5090",
"fax_number": "630-260-1230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 E ROOSEVELT RD",
"address_2": "STE 107",
"city": "WHEATON",
"state": "IL",
"postal_code": "601875589",
"telephone_number": "630-682-5090",
"fax_number": "630-260-1230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARGENT",
"first_name": "KRISTINA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-12",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "IL",
"license": "038007040",
"primary": false
},
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "IL",
"license": "038007040",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "02215708",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED WORK COMP",
"identifier": "601205300",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LBN",
"identifier": "271151301",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.