NPIMap

Organization Active NPI

Innovative Sports Medicine LLC

  • Chiropractor
  • Batavia, IL
National Provider Identifier
1881963163
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011756 Issued in IL
Legal business name
INNOVATIVE SPORTS MEDICINE LLC
Practice address
501 W Fabyan Pkwy
Batavia, IL 60510-1267
Phone
(630) 524-2445
NPI assigned
Dec 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Authorized official

Name
Eric Hestrup, D.C.NPI 1861709578
Title
Member
Phone
(630) 788-7990

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038011756 IL Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 070019008 IL

Addresses

Primary practice location

501 W Fabyan Pkwy
Batavia, IL 60510-1267

Mailing address

501 W Fabyan Pkwy
Batavia, IL 60510-1267
Phone (630) 524-2445

National Provider Directory

National Provider Directory

Locations

501 W Fabyan Pkwy
Batavia, IL 60510
Phone (630) 482-5940

Practitioners & affiliated clinicians

Practitioners 3

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": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369180800000",
    "number": "1881963163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W FABYAN PKWY",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101267",
            "telephone_number": "630-524-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W FABYAN PKWY",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101267",
            "telephone_number": "630-524-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2013-05-22",
        "status": "A",
        "authorized_official_last_name": "HESTRUP",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "630-788-7990",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011756",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.