Martin Chiropractic Clinic LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MARTIN CHIROPRACTIC CLINIC LTD

Practice address

1601 E Main St
Suite B
St Charles, IL 60174-2387

Phone

(630) 377-4955

NPI assigned

Oct 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jack R Martin, D.C.NPI 1003914342

Title

Owner

Phone

(630) 377-4955

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Richard Martin, DC

  • Chiropractor
  • St Charles, IL
  • NPI 1003914342
  Medicare reassignment NPD Authorized official
• Brett R Martin, D. C.

  • Chiropractor
  • St Charles, IL
  • NPI 1639409261
  NPD (past)

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1851580153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E MAIN ST",
            "address_2": "SUITE B",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742387",
            "telephone_number": "630-377-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E MAIN ST",
            "address_2": "SUITE B",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742387",
            "telephone_number": "630-377-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN CHIROPRACTIC CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-377-4955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038004270",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4532187",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Nicole Markham
• Marissa Markham, MOT, OTR/L
• Deborah S. Marqui, L.C.S.W.
• Melinda Marqui, DC, RN, CDCES
• Jacqueline Ann Marshall, L.C.S.W.
• Brett R Martin, D. C.
• Erin Elizabeth Martin
• Jack Richard Martin, DC
• Mary Ellen Martin, PT
• Sarah Martinez

• Chiropractor in St Charles, IL
• Providers in St Charles, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.