Individual provider Active NPI

Thomas Gerald Sircher, D.C.

  • Chiropractor
  • Libertyville, IL
National Provider Identifier
1902995327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
1641 N Milwaukee Ave
Suite 16
Libertyville, IL 60048-1350
Phone
(847) 367-0557
Fax
(847) 367-1680
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

1641 N Milwaukee Ave
Suite 16
Libertyville, IL 60048-1350

Mailing address

34067 N Campion Rd
Ingleside, IL 60041-9143
Phone (815) 363-9224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000362 IL Practitioner - Chiropractic 0547350399 Practice locations: Libertyville, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1641 N Milwaukee Ave
Suite 16
Libertyville, IL 60048-1350
Phone (847) 367-0557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-004408ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902995327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34067 N CAMPION RD",
            "city": "INGLESIDE",
            "state": "IL",
            "postal_code": "600419143",
            "telephone_number": "815-363-9224",
            "fax_number": "847-367-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 N MILWAUKEE AVE",
            "address_2": "SUITE 16",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481350",
            "telephone_number": "847-367-0557",
            "fax_number": "847-367-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRCHER",
        "first_name": "THOMAS",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.