Individual provider Active NPI

Robert Louis Donofrio, DC

  • Chiropractor
  • Elmhurst, IL
National Provider Identifier
1972673796
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008089 Issued in IL
Practice address
450 N York St
Elmhurst, IL 60126-2002
Phone
(630) 834-1114
Fax
(630) 834-3115
NPI assigned
Nov 9, 2006
Last updated
Jul 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038008089 IL Primary

Addresses

Primary practice location

450 N York St
Elmhurst, IL 60126-2002

Mailing address

450 N York St
Elmhurst, IL 60126-2002
Phone (630) 834-1114

Other identifiers 2

IdentifierTypeStateIssuer
02208440OtherBCBS
350042924OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081230000074 IL Practitioner - Chiropractic 8527120500 Practice locations: Elmhurst, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038008089ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1972673796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262002",
            "telephone_number": "630-834-1114",
            "fax_number": "630-834-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262002",
            "telephone_number": "630-834-1114",
            "fax_number": "630-834-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOFRIO",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02208440",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350042924",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; 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.