Individual provider Active NPI

Alexander E Earl, DC

  • Rehabilitation Chiropractor
  • Carol Stream, IL
National Provider Identifier
1043693575
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
038.012819 Issued in IL
Practice address
640 E Saint Charles Rd Ste 17
Carol Stream, IL 60188-3083
Phone
(630) 765-0575
NPI assigned
Jul 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 038.012819 IL Primary

Addresses

Primary practice location

640 E Saint Charles Rd Ste 17
Carol Stream, IL 60188-3083

Mailing address

640 E Saint Charles Rd Ste 107
Carol Stream, IL 60188-2614
Phone (630) 765-0575

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012819ILMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Clinic of Chiropractic P.C. CurrentSince Feb 27, 2023 Accepting new patients
Active Health & Restoration, LLC Rehabilitation PastSince Sep 11, 2022 Accepting new patients

Locations

955 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (706) 866-7575

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1043693575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E SAINT CHARLES RD STE 107",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882614",
            "telephone_number": "630-765-0575",
            "fax_number": "630-344-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E SAINT CHARLES RD STE 17",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601883083",
            "telephone_number": "630-765-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARL",
        "first_name": "ALEXANDER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038.012819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.