Individual provider Active NPI

Monica Cisneros, D.C.

  • Internist Chiropractor
  • Chicago, IL
National Provider Identifier
1831596980
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
038012729 Issued in IL
Practice address
2859 S Pulaski Rd
Chicago, IL 60623-5095
Phone
(773) 762-3333
Fax
(773) 922-5203
NPI assigned
Dec 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 038012729 IL
Rehabilitation Chiropractor 111NR0400X 038012729 IL
Sports Physician Chiropractor 111NS0005X 038012729 IL
Internist Chiropractor 111NI0900X 038012729 IL Primary

Addresses

Primary practice location

2859 S Pulaski Rd
Chicago, IL 60623-5095

Mailing address

1 Camberley CT
Hinsdale, IL 60521-4564
Phone (773) 762-3333

Other practice location 1

2425 W 22nd St Ste 206
Oak Brook, IL 60523-4652
Phone (773) 762-3333

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
038012729ILMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bioidmetrics Integrative Medical Institute, LLC Internist Current Accepting new patients

Locations

6715 Kingery Hwy
Willowbrook, IL 60527
Phone (630) 455-0212

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": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1831596980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAMBERLEY CT",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605214564",
            "telephone_number": "773-762-3333",
            "fax_number": "773-922-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2859 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606235095",
            "telephone_number": "773-762-3333",
            "fax_number": "773-922-5203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 W 22nd St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605234652",
            "country_code": "US",
            "telephone_number": "773-762-3333",
            "fax_number": "773-922-5203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-04",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": "038012729",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038012729",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038012729",
            "primary": false
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "IL",
            "license": "038012729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.