Individual provider Active NPI

Daniel Keith Mossell, D.C.

  • Chiropractor
  • Park Ridge, IL
National Provider Identifier
1184737199
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038006924 Issued in IL
Practice address
1 S Northwest Hwy Ste B2
Park Ridge, IL 60068-4240
Phone
(847) 768-9635
NPI assigned
Aug 16, 2006
Last updated
May 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038006924 IL Primary

Addresses

Primary practice location

1 S Northwest Hwy Ste B2
Park Ridge, IL 60068-4240

Mailing address

7140 N McAlpin Ave
Chicago, IL 60646-1220
Phone (773) 631-3840

Other identifiers 1

IdentifierTypeStateIssuer
412027646OtherFEIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100118000247 IL Practitioner - Chiropractic 1456493220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1420 N Northwest Hwy 411
Park Ridge, IL 60068-1310

1420N Northwest Hwy 411
Park Ridge, IL 60068-1310
Phone (847) 768-9635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038006924ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mossell Holistic Health Care LLC Chiropractor CurrentSince Oct 30, 2010 Accepting new patients
A K Health Center Inc Past Accepting new patients
Integrated Holistic Healthcare, S.C. Chiropractor PastSince Jun 10, 2016 Accepting new patients
Halcyon Health Chiropractic, S.C. Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1184737199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7140 N MCALPIN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606461220",
            "telephone_number": "773-631-3840",
            "fax_number": "773-631-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S NORTHWEST HWY STE B2",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684240",
            "telephone_number": "847-768-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSELL",
        "first_name": "DANIEL",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "412027646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.