Organization Active NPI

Michael L Belba DC PC

  • Chiropractor
  • Wilmette, IL
National Provider Identifier
1194993048
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MICHAEL L BELBA DC PC
Practice address
3207 Lake Ave
Suite 5a
Wilmette, IL 60091-1082
Phone
(847) 920-1822
Fax
(847) 920-1823
NPI assigned
Feb 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Dr. Michael Louis Belba, D.C.NPI 1154330959
Title
President
Phone
(847) 920-1822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X IL Primary

Addresses

Primary practice location

3207 Lake Ave
Suite 5a
Wilmette, IL 60091-1082

Mailing address

3207 Lake Ave
Suite 5a
Wilmette, IL 60091-1082
Phone (847) 920-1822

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819001490 IL Part B Supplier - Clinic/Group Practice 1951375617 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmette, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1194993048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 LAKE AVE",
            "address_2": "SUITE 5A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911082",
            "telephone_number": "847-920-1822",
            "fax_number": "847-920-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 LAKE AVE",
            "address_2": "SUITE 5A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911082",
            "telephone_number": "847-920-1822",
            "fax_number": "847-920-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L BELBA DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "BELBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-920-1822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.