NPIMap

Individual provider Active NPI

Justin B. Martindale, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1891090767
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011888 Issued in IL
Practice address
110 N Peoria St
Unit 301
Chicago, IL 60607-2396
Phone
(847) 774-8733
Fax
(312) 690-4880
NPI assigned
Jan 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011888 IL Primary

Addresses

Primary practice location

110 N Peoria St
Unit 301
Chicago, IL 60607-2396

Mailing address

110 N Peoria St
Unit 301
Chicago, IL 60607-2396
Phone (847) 774-8733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Pain & Wellness Chiropractor Past Accepting new patients
Physicians Sports & Injury Center, Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1891090767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N PEORIA ST",
            "address_2": "UNIT 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072396",
            "telephone_number": "847-774-8733",
            "fax_number": "312-690-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N PEORIA ST",
            "address_2": "UNIT 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072396",
            "telephone_number": "847-774-8733",
            "fax_number": "312-690-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINDALE",
        "first_name": "JUSTIN",
        "middle_name": "B.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.