Individual provider Active NPI

Gary L Becker, L.M.T.,D.C.

  • Chiropractor
  • Woodridge, IL
National Provider Identifier
1003841701
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038007884 Issued in IL
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

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0002207311OtherILBC/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

LicenseStateTypeSpecialty
038007884ILMDChiropractor
CERTIFICATEILMDAcupuncturist
4864OHMDMassage 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.

Verify at the official NPI Registry.