Edgewater Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EDGEWATER CHIROPRACTIC LLC

Practice address

6033 N Sheridan Rd # Cwo7S
Chicago, IL 60660-3003

Phone

(708) 320-8801

NPI assigned

Nov 9, 2022

Organization subpart

No

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

Authorized official

Name

Stephen George Shinault, DCNPI 1093283111

Title

Owner and Clinician

Phone

(708) 320-8801

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Stephen Shinault, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1093283111
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1871201707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 N SHERIDAN RD # CWO7S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603003",
            "telephone_number": "708-320-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 N SHERIDAN RD # CWO7S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603003",
            "telephone_number": "708-320-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "SHINAULT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER AND CLINICIAN",
        "authorized_official_telephone_number": "708-320-8801",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sshinault.janeapp.com",
            "affiliation": "N",
            "endpointDescription": "EHR and Scheduling Software",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6003 N Sheridan Rd CW07S",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Cole Dreskin Edgerton
• Edgewater Beach Foot and Ankle Center, P.C.
• Edgewater Rehabilitation Center
• Edgewater Satellite Senior Center
• Christopher Kirkwood Edginton, D.C.
• James F. Edgren, LCPC
• Edison Logistics

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.