Ellsworth Family Chiropractic, SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ELLSWORTH FAMILY CHIROPRACTIC, SC

Practice address

32 Main St
Suite B
Park Ridge, IL 60068-4060

Phone

(847) 318-1144

Fax

(847) 318-8866

NPI assigned

Oct 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Beau Jason Ellsworth, D.C.NPI 1740388263

Title

Owner

Phone

(847) 318-1144

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Ellsworth Family Chiropractic SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elite Rehabilitation Institute, SC

  • Chiropractor
  • Joliet, IL
  • NPI 1295689222
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Elite Rehabilitation Institute, SC

  • Chiropractor
  • Joliet, IL
  • NPI 1295689222
  NPPES parent name

Practitioners 2

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

• Beau J Ellsworth, D.C.

  • Chiropractor
  • Park Ridge, IL
  • NPI 1740388263
  Medicare reassignment Care Compare group NPD Authorized official
• Christine Alevritis, D.C.

  • Chiropractor
  • Wood Dale, IL
  • NPI 1760486716
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1861744815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 MAIN ST",
            "address_2": "SUITE B",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684060",
            "telephone_number": "847-318-1144",
            "fax_number": "847-318-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 MAIN ST",
            "address_2": "SUITE B",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684060",
            "telephone_number": "847-318-1144",
            "fax_number": "847-318-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH FAMILY CHIROPRACTIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-318-1144",
        "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": [],
    "endpoints": [],
    "other_names": []
}

• Elite Body Data, LLC
• Amanda Ray Elliott, LCSW
• Nancy S Elliott, DC
• Neil L Elliott, DC
• Amanda Dawn Ellis-Pelletier, DO
• Beau J Ellsworth, D.C.
• Alexander John Ellyin, MD
• Shayla Marie Emmett, MCMSC, PA-C
• Empowered You Counseling LLC
• Endodontic Associates of Park Ridge LTD

• Chiropractor in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.