FREDERICKS CHIROPRACTIC CENTER, LTD. (NPI# 1063673572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063673572 |
| Entity Type | Organization |
| Organization Name | FREDERICKS CHIROPRACTIC CENTER, LTD. |
| Practice Address |
166 N Gary Ave Carol Stream IL 60188-2093 |
| Practice Telephone | 6306655656 |
| Mailing Telephone | 6306655656 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | DR. KEVIN A FREDERICKS (PRESIDENT) |
| Authorized Official Telephone | 6306655656 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038005902 | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD OF ILLINOIS | 2215441 | 01 |
| IL | MEDICARE | 764930 | 01 |
| IL | UPIN | T38747 | 01 |
| Street Address |
166 N GARY AVE |
| City | CAROL STREAM |
| State | IL |
| Zip Code | 60188-2093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104906213 | Kevin A Fredericks | Chiropractor | 166 N Gary Ave, Carol Stream, IL 60188-2093 | 2006-10-16 |
| 1407914534 | George Eugene Radice | Chiropractor | 166 N Gary Ave, Carol Stream, IL 60188 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205496296 | Vita Pharmacy Inc | Pharmacy | 279-281 W Elk Trail Rd, Carol Stream, IL 60188 | 2019-06-20 |
| 1992287346 | Anjana Matiwala | Pharmacist | 1600 Mcconnor Parkway, Schaumburg, IL 60188 | 2018-09-02 |
| 1588145197 | Rita D Patel | Family Medicine | 858 Papoose Ct., Carol Stream, IL 60188 | 2018-08-22 |
| 1881103638 | Lineta Kundrotiene | Pharmacist | 615 Appaloosa Ct, Carol Stream, IL 60188 | 2017-09-25 |
| 1225409345 | Dr David Cavazos Dc LLC | Chiropractor | 66 E North Ave, Carol Stream, IL 60188 | 2015-10-15 |
| 1548657901 | Mark Babinski | Chiropractor | 1189 N Gary Ave, Carol Stream, IL 60188 | 2015-04-22 |
| 1609267095 | Jocelyn Tolentino | Obstetrics & Gynecology | 630 North Ave, Dept of Ob Gyn, Carol Stream, IL 60188 | 2015-02-06 |
| 1265798532 | William Vogds | Chiropractor | 25 W 330 Geneva Rd, Carol Stream, IL 60188 | 2012-04-11 |
| 1740557073 | Mary Jene Howe | Pharmacist | 540 Schmale, Carol Stream, IL 60188 | 2011-12-01 |
| 1992087878 | Patricia J Zurek | Pharmacist | 540 Schmale Rd, Carol Stream, IL 60188 | 2011-09-15 |
| Find all providers in zip 60188 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669094850 | Rawalji Inc | Chiropractor | 735 Buffalo Cir, Carol Stream, IL 60188-9105 | 2020-05-11 |
| 1982165205 | Brandon Mitchell Taylor | Chiropractor | 1363 New London Ct, Carol Stream, IL 60188-3393 | 2019-03-28 |
| 1104379544 | Darshan Gandhi | Chiropractor | 535 Chippewa Trl, Carol Stream, IL 60188-1589 | 2016-08-02 |
| 1225409345 | Dr David Cavazos Dc LLC | Chiropractor | 66 E North Ave, Carol Stream, IL 60188 | 2015-10-15 |
| 1548657901 | Mark Babinski | Chiropractor | 1189 N Gary Ave, Carol Stream, IL 60188 | 2015-04-22 |
| 1023449675 | Douglas Tansor Jr. | Chiropractor | 224 W Army Trail Rd, Carol Stream, IL 60188-9368 | 2013-12-09 |
| 1174879340 | Wheaton Medical Sc | Chiropractor | 640 E Saint Charles Rd Ste 204, 205, 206, Carol Stream, IL 60188-3083 | 2012-07-25 |
| 1265798532 | William Vogds | Chiropractor | 25 W 330 Geneva Rd, Carol Stream, IL 60188 | 2012-04-11 |
| 1063643104 | William Wright PC | Chiropractor | 1430 W Army Trail Rd, Carol Stream, IL 60188-4837 | 2009-08-06 |
| 1346303146 | Allan Kirchner-gomez | Chiropractor | 798 W Army Trail Rd, Carol Stream, IL 60188-9297 | 2006-12-19 |
| Find all providers in CAROL STREAM | ||||
| City | CAROL STREAM |
| Zip Code | 60188 |
Please comment or provide details below to improve the information on FREDERICKS CHIROPRACTIC CENTER, LTD..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.