NPIMap

Organization Active NPI

Chiropractic Plus

  • Chiropractor
  • Gurnee, IL
National Provider Identifier
1831385434
Registry record updated Oct 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038005092 Issued in IL
Legal business name
CHIROPRACTIC PLUS
Practice address
3930 Washington St
Suite B
Gurnee, IL 60031-5702
Phone
(847) 662-1600
Fax
(847) 662-1612
NPI assigned
Sep 18, 2007
Last updated
Oct 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2010

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

Authorized official

Name
Mark Fredrick, D.C.NPI 1467478404
Title
Owner/Doctor
Phone
(847) 662-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038005092 IL Primary

Addresses

Primary practice location

3930 Washington St
Suite B
Gurnee, IL 60031-5702

Mailing address

3930 Washington St
Suite B
Gurnee, IL 60031-5702
Phone (847) 662-1600

Other identifiers 3

IdentifierTypeStateIssuer
0040143639OtherILBCBS
0024940161OtherILBCBS
4915298OtherILBCBSIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1831385434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 WASHINGTON ST",
            "address_2": "SUITE B",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315702",
            "telephone_number": "847-662-1600",
            "fax_number": "847-662-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 WASHINGTON ST",
            "address_2": "SUITE B",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315702",
            "telephone_number": "847-662-1600",
            "fax_number": "847-662-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC PLUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "FREDRICK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "847-662-1600",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0040143639",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0024940161",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "4915298",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.