Individual provider Active NPI

Charles Andrew Maldonado, D.C.

  • Chiropractor
  • Hinsdale, IL
National Provider Identifier
1831467448
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012015 Issued in IL
Practice address
930 N York Rd Ste 100
Hinsdale, IL 60521-3595
Phone
(630) 654-9300
Fax
(630) 608-2855
NPI assigned
Dec 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012015 IL Primary

Addresses

Primary practice location

930 N York Rd Ste 100
Hinsdale, IL 60521-3595

Mailing address

438 Mills St
Hinsdale, IL 60521-2430

Other practice location 1

621 Plainfield Rd
Suite 311
Willowbrook, IL 60527-5343
Phone (630) 209-0508

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120501000792 IL Practitioner - Chiropractic 3072775485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

930 N York Rd
Suite 100
Hinsdale, IL 60521-3595
Phone (630) 654-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012015ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Chiropractic and Acupuncture, L.L.C. Chiropractor CurrentSince Feb 7, 2012 Accepting new patients

Locations

930 N York Rd
Ste 100
Hinsdale, IL 60521
Phone (630) 455-4545

621 Plainfield Rd
Ste 311
Willowbrook, IL 60527
Phone (630) 206-5606

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": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1831467448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 MILLS ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N YORK RD STE 100",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213595",
            "telephone_number": "630-654-9300",
            "fax_number": "630-608-2855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Plainfield Rd",
            "address_2": "Suite 311",
            "address_purpose": "LOCATION",
            "city": "Willowbrook",
            "state": "IL",
            "postal_code": "605275343",
            "country_code": "US",
            "telephone_number": "630-209-0508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.