Individual provider Active NPI

Adam Michael Bruene, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1932431210
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011623 Issued in IL
Practice address
2258 W Grand Ave
Chicago, IL 60612-1512
Phone
(773) 661-2070
Fax
(773) 697-8795
NPI assigned
Feb 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011623 IL Primary

Addresses

Primary practice location

2258 W Grand Ave
Chicago, IL 60612-1512

Mailing address

2258 W Grand Ave
Chicago, IL 60612-1512
Phone (773) 661-2070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100813000950 IL Practitioner - Chiropractic 7214061134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centre Physical Therapy Lincoln Park LLCGroup PAC ID 6406242460, 5 clinicians

Practice addresses (Care Compare)

2116 N Halsted St
Chicago, IL 60614-4316
Phone (708) 210-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bruene Chiropractic PC Chiropractor CurrentSince Oct 4, 2020 Accepting new patients
Centre Physical Therapy Lincoln Park LLC Chiropractor CurrentSince May 11, 2024 Accepting new patients
Neuroactive Health, LLC Chiropractor CurrentSince Oct 4, 2020 Accepting new patients

Locations

2258 W Grand Ave
Chicago, IL 60612
Phone (773) 661-2070

2835 N Sheffield Ave
Ste 411
Chicago, IL 60657
Phone (331) 215-4164

2116 N Halsted St
Chicago, IL 60614
Phone (708) 210-9800

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1932431210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121512",
            "telephone_number": "773-661-2070",
            "fax_number": "773-697-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2258 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121512",
            "telephone_number": "773-661-2070",
            "fax_number": "773-697-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUENE",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-11",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011623",
            "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 Sep 29, 2020; 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.