Active NPI
Gary L Becker, L.M.T.,D.C.
- Chiropractor
- Woodridge, IL
National Provider Identifier
1003841701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038007884
- Practice address
- 8200 Janes Ave
Woodridge, IL 60517-4303 - Phone
- (630) 739-9292
- Fax
- (630) 739-9342
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038007884 | IL | Primary |
| Massage Therapist | 225700000X | 4864 | OH | |
| Acupuncturist | 171100000X | CERTIFICATE | IL |
Addresses
Primary practice location
8200 Janes Ave
Woodridge, IL 60517-4303
Mailing address
319 N Weber Rd
# 379
Bolingbrook, IL 60490-1569
Phone (630) 739-9292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002207311 | Other | IL | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038007884 | IL | MD | Chiropractor |
| CERTIFICATE | IL | MD | Acupuncturist |
| 4864 | OH | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1003841701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 N WEBER RD",
"address_2": "# 379",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604901569",
"telephone_number": "630-739-9292",
"fax_number": "630-739-9342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8200 JANES AVE",
"city": "WOODRIDGE",
"state": "IL",
"postal_code": "605174303",
"telephone_number": "630-739-9292",
"fax_number": "630-739-9342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "GARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "L.M.T.,D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038007884",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OH",
"license": "4864",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "IL",
"license": "CERTIFICATE",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "0002207311",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Woodridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.