Individual provider Active NPI

Michael William Hausch, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1972791184
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008058 Issued in IL
Practice address
11001 S Kedzie Ave
Chicago, IL 60655-2221
Phone
(773) 585-5550
Fax
(773) 585-1061
NPI assigned
Oct 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 038008058 IL Primary

Addresses

Primary practice location

11001 S Kedzie Ave
Chicago, IL 60655-2221

Mailing address

11001 S Kedzie Ave
Chicago, IL 60655-2221
Phone (773) 585-5550

Other identifiers 8

IdentifierTypeStateIssuer
1623616OtherILBLUE CROSS BLUE SHIELD
364356477OtherILUNICARE
364356477OtherILUNITED HEALTH CARE
350049294OtherILRAILROAD MEDICARE
4046624OtherILCIGNA HEALTH CARE
364356477OtherILGREAT WEST
7972161OtherILAETNA
364356477OtherILHUMANA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071110000041 IL Practitioner - Chiropractic 6204924137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Greenwood Spine Care PLLCGroup PAC ID 7012249055, 3 clinicians

Practice addresses (Care Compare)

11001 S Kedzie Ave
Chicago, IL 60655-2221
Phone (773) 239-7777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood Spine Care PLLC Chiropractor CurrentSince Oct 1, 2019 Accepting new patients
Axis Physical Medicine PastSince Jul 7, 2014 Accepting new patients

Locations

11001 S Kedzie Ave
Chicago, IL 60655
Phone (773) 239-7777

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": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1972791184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 S KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552221",
            "telephone_number": "773-585-5550",
            "fax_number": "773-585-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 S KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552221",
            "telephone_number": "773-585-5550",
            "fax_number": "773-585-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSCH",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-12",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1623616",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "364356477",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "364356477",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350049294",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "4046624",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "364356477",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7972161",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "364356477",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.