Garth L. Edwards, MD, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038005184 Issued in IL

Practice address

22111 Governors Hwy
Richton Park, IL 60471-1249

Phone

(708) 748-5600

Fax

(708) 748-5635

NPI assigned

Jul 30, 2006

Last updated

Sep 22, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1983

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edwards Chiropractic Clinic P.C

  • Nutrition Chiropractor
  • Richton Park, IL
  • NPI 1164649976
  Medicare reassignment Authorized official
• Edwards Chiropractic Clinic

  dba HealthSource of Richton Park

  • Chiropractor
  • Richton Park, IL
  • NPI 1760853857
  NPD (past) Authorized official

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1013922673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22111 GOVERNORS HWY",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711249",
            "telephone_number": "708-748-5600",
            "fax_number": "708-748-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22111 GOVERNORS HWY",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711249",
            "telephone_number": "708-748-5600",
            "fax_number": "708-748-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "GARTH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD, DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dove Mandela (Dove Mandela Home Healthcare)
• Dove Mandela (Dove Mandela Home Health Care)
• Maceo Edmonds
• Edwards Chiropractic Clinic (HealthSource of Richton Park)
• Edwards Chiropractic Clinic P.C
• Elite Life Skills Coaching
• Tamia Evans
• Faith Is Key Counseling NFP
• Family Eye Centers LLC
• Mary Elizabeth Fleming, CCC-SLP

• Chiropractor in Richton Park, IL
• Providers in Richton Park, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.