Organization Active NPI

Advanced Rehabilitation Center,P.C.

  • Chiropractor
  • Deerfield, IL
National Provider Identifier
1972613701
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
060-008205 Issued in IL
Legal business name
ADVANCED REHABILITATION CENTER,P.C.
Practice address
1020 Milwaukee Ave Ste 242
Deerfield, IL 60015-3562
Phone
(847) 293-5690
Fax
(847) 541-7933
NPI assigned
Aug 30, 2006
Last updated
Nov 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Authorized official

Name
Aleksandr Naroditsky, D.C.NPI 1336259282
Title
President
Phone
(847) 293-5690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 060-008205 IL Primary

Addresses

Primary practice location

1020 Milwaukee Ave Ste 242
Deerfield, IL 60015-3562

Mailing address

12829 W Sanctuary LN
Lake Bluff, IL 60044-1167
Phone (847) 293-5690

Other identifiers 1

IdentifierTypeStateIssuer
038009089MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820000925 IL Part B Supplier - Clinic/Group Practice 0941274435 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Bluff, IL

National Provider Directory

National Provider Directory

Locations

2549 Waukegan Rd
Bannockburn, IL 60015
Phone (833) 831-8163

4925 N Pulaski Rd
Chicago, IL 60630
Phone (773) 478-9445

401 S Milwaukee Ave
Ste 220
Wheeling, IL 60090
Phone (847) 541-7933

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1972613701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12829 W SANCTUARY LN",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441167",
            "telephone_number": "847-293-5690",
            "fax_number": "847-541-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MILWAUKEE AVE STE 242",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153562",
            "telephone_number": "847-293-5690",
            "fax_number": "847-541-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REHABILITATION CENTER,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "NARODITSKY",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-293-5690",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "060-008205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009089",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.