Individual provider Active NPI

Michelle Blanton, DC

  • Chiropractor
  • Oak Forest, IL
National Provider Identifier
1083098644
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012830 Issued in IL
Practice address
5424 159TH St
Oak Forest, IL 60452-3248
Phone
(708) 577-5003
NPI assigned
Jul 14, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012830 IL Primary

Addresses

Primary practice location

5424 159TH St
Oak Forest, IL 60452-3248

Mailing address

2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824

Other practice location 1

1S132 Summit Ave Ste 307
Oakbrook Terrace, IL 60181-3942
Phone (630) 705-1475

Other practice location 2

1S132 Summit Ave Ste 307
Oakbrook Terrace, IL 60181-3942
Phone (630) 705-1475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150825004648 IL Practitioner - Chiropractic 1254646516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16335 Harlem Ave
Suite 150 2
Tinley Park, IL 60477-2574
Phone (708) 829-3941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012830ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center of Oak Forest LLC Chiropractor CurrentSince Oct 25, 2017 Accepting new patients
Xclusive Chiropractic LLC Chiropractor CurrentSince Jan 12, 2023 Accepting new patients

Locations

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523
Phone (800) 613-0922

5424 159th St
Oak Forest, IL 60452
Phone (708) 577-5003

16335 Harlem Ave
Ste 1502
Tinley Park, IL 60477
Phone (708) 829-3941

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, 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": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083098644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 159TH ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523248",
            "telephone_number": "708-577-5003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1S132 Summit Ave Ste 307",
            "address_purpose": "LOCATION",
            "city": "Oakbrook Terrace",
            "state": "IL",
            "postal_code": "601813942",
            "country_code": "US",
            "telephone_number": "630-705-1475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1S132 Summit Ave Ste 307",
            "address_purpose": "LOCATION",
            "city": "Oakbrook Terrace",
            "state": "IL",
            "postal_code": "601813942",
            "country_code": "US",
            "telephone_number": "630-705-1475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANTON",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.