Individual provider Active NPI

Anthony Czahor, D.C.

  • Chiropractor
  • Park Ridge, IL
National Provider Identifier
1841731635
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013086 Issued in IL
Practice address
2100 Walnut St
Park Ridge, IL 60068-1760
Phone
(847) 312-8179
NPI assigned
Mar 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013086 IL Primary

Addresses

Primary practice location

2100 Walnut St
Park Ridge, IL 60068-1760

Mailing address

2100 Walnut St
Park Ridge, IL 60068-1760
Phone (847) 312-8179

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808003004 IL Practitioner - Chiropractic 8426306366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

333 E Benton PL
Suite 104
Chicago, IL 60601-7411
Phone (312) 265-0655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013086ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Wellness Source at Lakeshore East SC Chiropractor CurrentSince Aug 1, 2018 Accepting new patients

Locations

333 E Benton Pl
Ste 104
Chicago, IL 60601
Phone (312) 265-0655

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": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1841731635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WALNUT ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681760",
            "telephone_number": "847-312-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WALNUT ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681760",
            "telephone_number": "847-312-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZAHOR",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.