NPIMap

Organization Active NPI

Lighthouse Family Chiropractic, LTD

  • Chiropractor
  • St Charles, IL
National Provider Identifier
1932233269
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008235 Issued in IL
Legal business name
LIGHTHOUSE FAMILY CHIROPRACTIC, LTD
Practice address
525 Tyler Rd
Unit R-1
St Charles, IL 60174-3305
Phone
(630) 443-4411
Fax
(630) 443-7351
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Authorized official

Name
Sheryar Masud
Title
Owner
Phone
(630) 443-4411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038008235 IL Primary

Addresses

Primary practice location

525 Tyler Rd
Unit R-1
St Charles, IL 60174-3305

Mailing address

525 Tyler Rd
Unit R-1
St Charles, IL 60174-3305
Phone (630) 443-4411

Other identifiers 1

IdentifierTypeStateIssuer
04527125OtherILBLUE CROSS BLUE SHEILD

National Provider Directory

National Provider Directory

Locations

525 Tyler Rd
Unit R1
St Charles, IL 60174
Phone (630) 443-4411

Practitioners & affiliated clinicians

Practitioners 1

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1932233269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 TYLER RD",
            "address_2": "UNIT R-1",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601743305",
            "telephone_number": "630-443-4411",
            "fax_number": "630-443-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TYLER RD",
            "address_2": "UNIT R-1",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601743305",
            "telephone_number": "630-443-4411",
            "fax_number": "630-443-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE FAMILY CHIROPRACTIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "MASUD",
        "authorized_official_first_name": "SHERYAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-443-4411"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "04527125",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.