Individual provider Active NPI

Patrick Labelle, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1194804799
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010074 Issued in IL
Practice address
1255 W Diversey Pkwy
Chicago, IL 60614-1201
Phone
(773) 472-0700
Fax
(733) 472-0300
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010074 IL Primary

Addresses

Primary practice location

1255 W Diversey Pkwy
Chicago, IL 60614-1201

Mailing address

1255 W Diversey Pkwy
Chicago, IL 60614-1201
Phone (773) 472-0700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000189 IL Practitioner - Chiropractic 4385823491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1255 W Diversey Pkwy
Chicago, IL 60614-1201
Phone (773) 472-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010074ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vincent Domingo DC CSCS Professional Corporation Chiropractor CurrentSince Jul 21, 2014 Accepting new patients
Patrick Labelle DC SC Chiropractor CurrentSince Jul 21, 2014 Accepting new patients

Locations

1255 W Diversey Pkwy
Chicago, IL 60614
Phone (773) 472-0700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1194804799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W DIVERSEY PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "773-472-0700",
            "fax_number": "733-472-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W DIVERSEY PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "773-472-0700",
            "fax_number": "733-472-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABELLE",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010074",
            "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 Jul 15, 2015; 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.