Individual provider Active NPI

Jason Lee Smith, DC

  • Chiropractor
  • Bartlett, IL
National Provider Identifier
1952500720
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009652 Issued in IL
Practice address
952 Bryn Mawr Ave
Bartlett, IL 60103-5608
Phone
(773) 306-6223
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038009652 IL Primary

Addresses

Primary practice location

952 Bryn Mawr Ave
Bartlett, IL 60103-5608

Mailing address

952 Bryn Mawr Ave
Bartlett, IL 60103-5608
Phone (773) 306-6223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231115002708 IL Practitioner - Chiropractic 0840647673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038009652ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
606 Health Chiropractor CurrentSince Apr 6, 2025 Accepting new patients
Wicker Park Chiropractic Health Past Accepting new patients

Locations

158 Bartlett Plz
Bartlett, IL 60103
Phone (630) 830-2121

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1952500720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 BRYN MAWR AVE",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601035608",
            "telephone_number": "773-306-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 BRYN MAWR AVE",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601035608",
            "telephone_number": "773-306-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.