Organization Active NPI

Norridge Chiropractic Clinic LTD

  • Chiropractor
  • Norridge, IL
National Provider Identifier
1932218583
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038004983 Issued in IL
Legal business name
NORRIDGE CHIROPRACTIC CLINIC LTD
Practice address
7830 W Lawrence Ave
Norridge, IL 60706
Phone
(708) 457-8000
Fax
(708) 457-1333
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Mr. Frank J Martusciello, DC DABCONPI 1891981437
Title
Clinic Director
Phone
(708) 457-8000

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 038004983 IL Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038008935 IL

Addresses

Primary practice location

7830 W Lawrence Ave
Norridge, IL 60706

Mailing address

7830 W Lawrence Ave
Norridge, IL 60706
Phone (708) 457-8000

Other identifiers 2

IdentifierTypeStateIssuer
277958200OtherILDEPT OF LABOR
1682591OtherILBCBS

Other names 1

  • Total Life Chiropractic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503001019 IL Part B Supplier - Clinic/Group Practice 2062400708 Receives reassigned benefits from 4 practitioners
Practice locations: Norridge, IL; Willow Springs, IL

National Provider Directory

National Provider Directory

Locations

8323 W Lawrence Ave
Ste A
Norridge, IL 60706

8323 W Lawrence Ave
Ste Ab
Norridge, IL 60706
Phone (708) 457-8000

Practitioners & affiliated clinicians

Practitioners 10

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1932218583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 W LAWRENCE AVE",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "60706",
            "telephone_number": "708-457-8000",
            "fax_number": "708-457-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 W LAWRENCE AVE",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "60706",
            "telephone_number": "708-457-8000",
            "fax_number": "708-457-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORRIDGE CHIROPRACTIC CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "MARTUSCIELLO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "708-457-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC  DABCO"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004983",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "277958200",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1682591",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Total Life Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.