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

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

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 and National Provider Directory roles.

• Bhealth LLC

  • Physical Therapist
  • Oak Park, IL
  • NPI 1285217034

  IL

  Medicare reassignment NPD
• Fuller Health Group SC

  • Chiropractor
  • Oak Park, IL
  • NPI 1689806358
  NPD Authorized official

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
• CHI Ming Henry Fung, D.D.S.
• Jimmy Fung, D.D.S.

• All providers in Oak Park, IL
• 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.