Active NPI
Lucas C McCully, DC
- Chiropractor
- Crystal Lake, IL
National Provider Identifier
1154567659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH60043071
- Practice address
- 820 E Terra Cotta Ave Ste 144
Crystal Lake, IL 60014-3634 - Phone
- (815) 526-3658
- NPI assigned
- Jan 5, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH60043071 | WA | Primary |
Addresses
Primary practice location
820 E Terra Cotta Ave Ste 144
Crystal Lake, IL 60014-3634
Mailing address
820 E Terra Cotta Ave Ste 144
Crystal Lake, IL 60014-3634
Phone (815) 526-3658
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
820 E Terra Cotta Ave
Suite 144
Crystal Lake, IL 60014-3634
Phone (815) 526-3658
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH60043071 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McCully Atlas Spinal Care Chiropractic, P.C. | Chiropractor | Current | Accepting new patients |
Locations
4655 Hoen Ave
Ste 8
Santa Rosa, CA 95405
Phone (707) 545-8881
820 E Terra Cotta Ave
Ste 144
Crystal Lake, IL 60014
Phone (815) 526-3658
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1154567659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 E TERRA COTTA AVE STE 144",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600143634",
"telephone_number": "815-526-3658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 E TERRA COTTA AVE STE 144",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600143634",
"telephone_number": "815-526-3658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLY",
"first_name": "LUCAS",
"middle_name": "C",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-05",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH60043071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.