Nicole Desiree Beavers, D.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1255 S State St Unit 6
Chicago, IL 60605

Phone

(312) 880-0808

Fax

(312) 880-0810

NPI assigned

Nov 11, 2011

Last updated

Sep 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Juarez Chiropractic Inc.

  • Chiropractor
  • Chicago, IL
  • NPI 1790080232
  NPD (past)

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1942587456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 VILLAGE CENTER DR STE 205",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605274526",
            "telephone_number": "630-920-4670",
            "fax_number": "630-920-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 S STATE ST UNIT 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60605",
            "telephone_number": "312-880-0808",
            "fax_number": "312-880-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVERS",
        "first_name": "NICOLE",
        "middle_name": "DESIREE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-11",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012045",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie A Beaulieu, BCBA
• Beautiful Beginnings, Happy Endings LLC
• Beautiful Minds Counseling PLLC
• Beauty Dental Inc (Ida L Aguilar DDS)
• Jenaye Beavers
• Kathleen Beavis
• Allison Bebar
• Jacob Bebar
• John Patrick Farouk Bebawy, M.D.
• Brenda Beben, RD

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.