Organization Active NPI

SJ Chiropractic LLC

  • Chiropractor
  • Oak Park, IL
National Provider Identifier
1871361048
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SJ CHIROPRACTIC LLC
Practice address
715 Lake St Ste 271
Oak Park, IL 60301-1411
Phone
(708) 848-2730
Fax
(708) 848-2739
NPI assigned
Dec 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Dr. Simone J Joseph, D.C.NPI 1114269644
Title
President
Phone
(708) 848-2730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

715 Lake St Ste 271
Oak Park, IL 60301-1411

Mailing address

715 Lake St Ste 271
Oak Park, IL 60301-1411
Phone (708) 848-2730

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240208001527 IL Part B Supplier - Clinic/Group Practice 3375986136 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Park, IL

National Provider Directory

National Provider Directory

Locations

715 Lake St
Ste 271
Oak Park, IL 60301
Phone (708) 848-2730

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1871361048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 LAKE ST STE 271",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011411",
            "telephone_number": "708-848-2730",
            "fax_number": "708-848-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LAKE ST STE 271",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011411",
            "telephone_number": "708-848-2730",
            "fax_number": "708-848-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJ CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-848-2730",
        "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": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.