Brian Mendoza, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038012117 Issued in IL

Practice address

13657 Cicero Ave
Crestwood, IL 60445-1936

Phone

(708) 396-2500

Fax

(708) 396-8605

NPI assigned

Jan 23, 2012

Last updated

Dec 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Spinal Care,LTD.Group PAC ID 3870682495, 4 clinicians

Practice addresses (Care Compare)

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.

• Illinois Spinal Care,LTD.

  • Chiropractor
  • Elmhurst, IL
  • NPI 1356540561
  Medicare reassignment Care Compare group NPD
• Crestwood Chiropractic and Rehab

  • Chiropractor
  • Crestwood, IL
  • NPI 1659461309
  NPD (past)
• Health on Earth Wellness Centers LLC

  dba Crestwood Chiropractic and Rehab

  • Chiropractor
  • Crestwood, IL
  • NPI 1629270954
  NPD (past)

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1154692127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 N YORK ST",
            "address_2": "STE 301",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262784",
            "telephone_number": "630-617-9790",
            "fax_number": "630-559-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13657 CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451936",
            "telephone_number": "708-396-2500",
            "fax_number": "708-396-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "BRIAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-23",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Jean McGinnis, M.ED.
• Patricia McGoldrick
• Ashley Lauren McGowan, SLP
• Medication Management Partners (Medication Management Partners, LLC)
• Richard Melton, LCSW
• Mimoza Metarapi, PHARMD, BCPS, BCGP
• Metro Primary Care Associates LLC
• Michael a. Luckett D.M.D. & Associates (Rivercrest), LTD. (DentalWorks)
• Midwest Physician Group LTD (Midwest Physician Center of Crestwood)
• Miinedoctor, Inc.

• Chiropractor in Crestwood, IL
• Providers in Crestwood, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.