Individual provider Active NPI

Randal R Cybulski, DC

  • Chiropractor
  • Plainfield, IL
National Provider Identifier
1063717676
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-011835 Issued in IL
Practice address
12337 S Route 59
Suite 119
Plainfield, IL 60585-4625
Phone
(815) 267-6263
Fax
(815) 782-8549
NPI assigned
Jan 13, 2011
Last updated
Oct 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-011835 IL Primary

Addresses

Primary practice location

12337 S Route 59
Suite 119
Plainfield, IL 60585-4625

Mailing address

12337 S Route 59
Suite 119
Plainfield, IL 60585-4625
Phone (815) 267-6263

Other names 1

  • Dr. Randy R Cybulski Other name

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
038-011835ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Sports and Spinal Rehab Chiropractor Current Accepting new patients

Locations

12337 S Route 59
Unit 119
Plainfield, IL 60585
Phone (815) 254-0044

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1063717676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12337 S ROUTE 59",
            "address_2": "SUITE 119",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605854625",
            "telephone_number": "815-267-6263",
            "fax_number": "815-782-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12337 S ROUTE 59",
            "address_2": "SUITE 119",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605854625",
            "telephone_number": "815-267-6263",
            "fax_number": "815-782-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYBULSKI",
        "first_name": "RANDAL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-011835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "CYBULSKI",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.