NPIMap

Organization Active NPI

Chicago Bone & Joint Clinic LLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1962053264
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHICAGO BONE & JOINT CLINIC LLC
Practice address
6457 S Pulaski Rd
Chicago, IL 60629-5148
Phone
(312) 972-6017
NPI assigned
Sep 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Authorized official

Name
Dr. Richard A Vallandigham, DC
Title
Sole Member, Founder
Phone
(312) 972-6017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

6457 S Pulaski Rd
Chicago, IL 60629-5148

Mailing address

PO Box 11040
Chicago, IL 60611-0001
Phone (312) 972-6017

Other identifiers 1

IdentifierTypeStateIssuer
1952341596MedicaidIL

Other names 1

  • Chicago Bone & Joint Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@chicagobonejointclinic.com Direct

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1962053264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11040",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606110001",
            "telephone_number": "312-972-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6457 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "312-972-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO BONE & JOINT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "VALLANDIGHAM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER, FOUNDER",
        "authorized_official_telephone_number": "312-972-6017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952341596",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@chicagobonejointclinic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6457 S Pulaski Rd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606295148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Chicago Bone & Joint Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.