Individual provider Active NPI

Andrew K Basham, D.C.

  • Chiropractor
  • Bourbonnais, IL
National Provider Identifier
1861549818
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-008050 Issued in IL
Practice address
232 Main St NW
Suite 201
Bourbonnais, IL 60914-1938
Phone
(815) 939-4900
Fax
(815) 939-4951
NPI assigned
Jan 4, 2007
Last updated
May 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-008050 IL Primary

Addresses

Primary practice location

232 Main St NW
Suite 201
Bourbonnais, IL 60914-1938

Mailing address

460 Oak Run Dr Apt 7
Suite a
Bourbonnais, IL 60914-1760
Phone (309) 530-1491

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008050ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Family Chiropractic Chiropractor PastSince Mar 2, 2019 Accepting new patients
Grundy County Pain Center SC Chiropractor Past Accepting new patients
Nims Chiropractic LTD. Chiropractor PastSince Apr 4, 2026 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1861549818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 OAK RUN DR APT 7",
            "address_2": "SUITE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141760",
            "telephone_number": "309-530-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 MAIN ST NW",
            "address_2": "SUITE 201",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141938",
            "telephone_number": "815-939-4900",
            "fax_number": "815-939-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHAM",
        "first_name": "ANDREW",
        "middle_name": "K",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.