Elgin Physical Medicine SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ELGIN PHYSICAL MEDICINE SC

Practice address

609 Dundee Ave
Elgin, IL 60120-3820

Phone

(773) 278-9525

Fax

(773) 337-9135

NPI assigned

Sep 26, 2022

Organization subpart

No

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

Authorized official

Name

Eugene M Jao, MD

Title

President

Phone

(312) 961-6611

Specialties & licenses 1

Addresses

Tax ID family

Elgin Physical Medicine SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elgin Physical Medicine SC

  • Chiropractor
  • Rockford, IL
  • NPI 1154262384
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Elgin Physical Medicine SC

  • Chiropractor
  • Rockford, IL
  • NPI 1154262384
  NPPES parent name

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1942923776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4782",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606804782",
            "telephone_number": "773-278-9525",
            "fax_number": "773-337-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 DUNDEE AVE",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203820",
            "telephone_number": "773-278-9525",
            "fax_number": "773-337-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN PHYSICAL MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "JAO",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-961-6611",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elgin Pain & Headache Center, Inc.
• Elgin Pain & Headache Center, S.C.
• Elgin Pediatric Therapy Inc
• Elgin Pharmacy Inc
• Elgin Physical Health Center
• Elgin Skilled Nursing Facility LLC
• Elgin Surgicare LLC
• Elgin Universal Dental
• Elgin Universal Dental LLC
• Elgin Well Child Conference

• Chiropractor in Elgin, IL
• Providers in Elgin, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.