Individual provider Active NPI

Jeff M Heddles, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1932131885
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009579 Issued in IL
Practice address
1600 S Indiana Ave
Unit B
Chicago, IL 60616-4732
Phone
(312) 922-9868
Fax
(312) 922-9869
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-009579 IL Primary

Addresses

Primary practice location

1600 S Indiana Ave
Unit B
Chicago, IL 60616-4732

Mailing address

1600 S Indiana Ave
Unit B
Chicago, IL 60616-4732
Phone (312) 922-9868

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

State licenses

LicenseStateTypeSpecialty
038-009579ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1932131885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S INDIANA AVE",
            "address_2": "UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164732",
            "telephone_number": "312-922-9868",
            "fax_number": "312-922-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S INDIANA AVE",
            "address_2": "UNIT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164732",
            "telephone_number": "312-922-9868",
            "fax_number": "312-922-9869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDDLES",
        "first_name": "JEFF",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009579",
            "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 Jan 18, 2012; 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.