Individual provider Active NPI

Nancy Portillo, D.C.

  • Chiropractor
  • St Charles, IL
National Provider Identifier
1942573597
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012132 Issued in IL
Practice address
3755 E Main St
Suite 158
St Charles, IL 60174-2463
Phone
(630) 377-3344
NPI assigned
Feb 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 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 038012132 IL Primary

Addresses

Primary practice location

3755 E Main St
Suite 158
St Charles, IL 60174-2463

Mailing address

3755 E Main St
Suite 158
St Charles, IL 60174-2463
Phone (630) 377-3344

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
038012132ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Inmotion Whole Health Center, Inc Chiropractor CurrentSince Aug 30, 2012 Accepting new patients
Optimal Care Chiropractic Chiropractor CurrentSince Aug 30, 2020 Accepting new patients

Locations

2759 US Highway 34
Oswego, IL 60543
Phone (630) 554-2873

3755 E Main St
Ste 158
St Charles, IL 60174
Phone (630) 377-3344

Organizations & group practices 2

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": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1942573597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 E MAIN ST",
            "address_2": "SUITE 158",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742463",
            "telephone_number": "630-377-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 E MAIN ST",
            "address_2": "SUITE 158",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742463",
            "telephone_number": "630-377-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012132",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 13, 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.