NPIMap

Organization Active NPI

Andickerson, Inc

Doing business as Sports and Spine Chiropractic

  • Chiropractor
  • Oswego, IL
National Provider Identifier
1871978916
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011384 Issued in IL
Legal business name
ANDICKERSON, INC
Doing business as
Sports and Spine Chiropractic
Practice address
83 Templeton Dr
Unit C
Oswego, IL 60543-7019
Phone
(630) 554-9991
Fax
(630) 554-9992
NPI assigned
Jul 29, 2015
Last updated
Apr 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Dr. Ashley Dickerson, DCNPI 1659512598
Title
Owner
Phone
(630) 554-9991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038011384 IL Primary

Addresses

Primary practice location

83 Templeton Dr
Unit C
Oswego, IL 60543-7019

Mailing address

83 Templeton Drive
Unit C
Oswego, IL 60543-7019
Phone (630) 554-9991

Other names 1

  • Sports and Spine Chiropractic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1871978916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 TEMPLETON DRIVE",
            "address_2": "UNIT C",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437019",
            "telephone_number": "630-554-9991",
            "fax_number": "630-554-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 TEMPLETON DR",
            "address_2": "UNIT C",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437019",
            "telephone_number": "630-554-9991",
            "fax_number": "630-554-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDICKERSON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-554-9991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports and Spine Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.