Loren Davis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038008320 Issued in IL

Practice address

16622 W. 159TH St.
Suite 500
Lockport, IL 60441-8015

Phone

(815) 838-7746

Fax

(815) 838-5090

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: loren.davis@25253780.chartlogic.direct-ci.com

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.

• Chicago Anti Aging Institute SC

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Lockport, IL
  • NPI 1003376245

  IL

  Medicare reassignment Care Compare group NPD Authorized official

Specialty

Chiropractic

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Group practices

Chicago Anti Aging Institute SC 2 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1891917795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16622 W. 159TH ST.",
            "address_2": "SUITE 500",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418015",
            "telephone_number": "815-838-7746",
            "fax_number": "815-838-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16622 W. 159TH ST.",
            "address_2": "SUITE 500",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418015",
            "telephone_number": "815-838-7746",
            "fax_number": "815-838-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LOREN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "P00864465",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9932868",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph William Cunnane, ATC
• Kristine D Czaplicki, M.ED
• Jeffrey John D'Adam, PTA
• Daniel L Clark DO LTD
• Breanna Darcy
• Ashley Delnegro, LMT
• Dental Professionals of Illinois, PC
• Dental Sleep Center Richard a Craig DDS LTD
• Des Plaines Valley Foot Care Inc
• Darren Allen Deskin, DC

• All providers in Lockport, IL
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.