NPIMap

Organization Active NPI

Evolve Chiropractic Rockford PLLC

Doing business as Evolve Chiropractic Rockford

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1881238434
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EVOLVE CHIROPRACTIC ROCKFORD PLLC
Doing business as
Evolve Chiropractic Rockford
Practice address
2606 Broadway Ste 1a
Rockford, IL 61108-5769
Phone
(815) 397-3744
NPI assigned
Nov 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Scott Cruse, DCNPI 1003103938
Title
Owner
Phone
(224) 250-3526

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

2606 Broadway Ste 1a
Rockford, IL 61108-5769

Mailing address

2606 Broadway Ste 1a
Rockford, IL 61108-5769

Other names 1

  • Evolve Chiropractic Rockford Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201229002180 IL Part B Supplier - Clinic/Group Practice 1658784236 Receives reassigned benefits from 7 practitioners
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Locations

431 Phelps Ave
Rockford, IL 61108

2606 Broadway
Rockford, IL 61108
Phone (815) 397-3744

2606 Broadway
Ste 1A
Rockford, IL 61108
Phone (815) 397-3744

Practitioners & affiliated clinicians

Practitioners 10

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": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1881238434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 BROADWAY STE 1A",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611085769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 BROADWAY STE 1A",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611085769",
            "telephone_number": "815-397-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE CHIROPRACTIC ROCKFORD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "CRUSE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-250-3526",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Chiropractic Rockford",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolve Chiropractic Rockford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.