Individual provider Active NPI

Sikirat A. Yusuf, DC

  • Chiropractor
  • Homewood, IL
National Provider Identifier
1952307761
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009479 Issued in IL
Practice address
18216 Harwood Ave Ste 1S
Homewood, IL 60430-2152
Phone
(708) 891-2006
Fax
(708) 891-2076
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-009479 IL Primary

Addresses

Primary practice location

18216 Harwood Ave Ste 1S
Homewood, IL 60430-2152

Mailing address

15504 Dobson Ave
Dolton, IL 60419-2709
Phone (708) 891-2006

Other practice location 1

944 East 162nd St.
South Holland, IL 60473
Phone (708) 891-2006

Other identifiers 2

IdentifierTypeStateIssuer
038009479MedicaidIL
1132889OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090113000779 IL Practitioner - Chiropractic 6709949027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009479ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1952307761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15504 DOBSON AVE",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192709",
            "telephone_number": "708-891-2006",
            "fax_number": "708-891-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18216 HARWOOD AVE STE 1S",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302152",
            "telephone_number": "708-891-2006",
            "fax_number": "708-891-2076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "944 East 162nd St.",
            "address_purpose": "LOCATION",
            "city": "South Holland",
            "state": "IL",
            "postal_code": "60473",
            "country_code": "US",
            "telephone_number": "708-891-2006",
            "fax_number": "708-891-2076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUSUF",
        "first_name": "SIKIRAT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009479",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1132889",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.