Brian Jay Fuller, D.C.

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

038010329 Issued in IL

Practice address

1010 Lake St Ste 400
Oak Park, IL 60301-1135

Phone

(708) 705-9494

Fax

(708) 221-7108

NPI assigned

Jun 13, 2006

Last updated

Dec 11, 2020By 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bhealth LLC

  • Physical Therapist
  • Oak Park, IL
  • NPI 1285217034
  Medicare reassignment NPD
• Fuller Health Group SC

  • Chiropractor
  • Oak Park, IL
  • NPI 1689806358
  NPD Authorized official
• Fuller Health Group LLC

  • Nutrition Chiropractor
  • Chicago, IL
  • NPI 1962647792
  Authorized official Same address or phone

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1073556544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 400",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011135",
            "telephone_number": "708-705-9494",
            "fax_number": "708-221-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 400",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011135",
            "telephone_number": "708-705-9494",
            "fax_number": "708-221-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BRIAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": "038010329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Lou Friedman, LMFT
• Jereme Froehlich, CRNA
• Jennifer C Froemel, M.A., L.C.P.C.
• John Brian Fuente, LPC
• Fuller Health Group SC
• Daniel P Fulton, MA
• Funches Healthcare PLLC Dba Virtual Health 78 & Wellness Center
• Functional Health and Wellness (FYZICAL Therapy and Balance Center of South Oak Park)
• CHI Ming Henry Fung, D.D.S.
• Jimmy Fung, D.D.S.

• Nutrition Chiropractor in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Nutrition Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.