Individual provider Active NPI

Glenn Lemus, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1184127029
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013068 Issued in IL
Practice address
5738 S Pulaski Rd
Chicago, IL 60629-4437
Phone
(773) 278-9525
NPI assigned
Mar 16, 2018
Last updated
Mar 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 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 038013068 IL Primary

Addresses

Primary practice location

5738 S Pulaski Rd
Chicago, IL 60629-4437

Mailing address

445 E Ohio St Apt 2103
Chicago, IL 60611-3339
Phone (773) 307-4783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
038013068ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica SC Chiropractor Past Accepting new patients
LJ Medication, LTD. PastSince Oct 6, 2019 Accepting new patients
La Clinica SC Chiropractor Past Accepting new patients

Organizations & group practices 3

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": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1184127029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E OHIO ST APT 2103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113339",
            "telephone_number": "773-307-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5738 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294437",
            "telephone_number": "773-278-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMUS",
        "first_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.