Organization Active NPI

Quill Family Chiropractic

Doing business as Bolingbrook Family Chiropractic

  • Chiropractor
  • Bolingbrook, IL
National Provider Identifier
1205394970
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
QUILL FAMILY CHIROPRACTIC
Doing business as
Bolingbrook Family Chiropractic
Practice address
550 E Boughton Rd Ste 150
Bolingbrook, IL 60440-2189
Phone
(630) 739-1791
NPI assigned
Mar 12, 2019
Last updated
Mar 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Authorized official

Name
Dr. Mitchell Quill, DCNPI 1144775800
Title
Owner
Phone
(224) 301-3043

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
Chiropractor 111N00000X Primary

Addresses

Primary practice location

550 E Boughton Rd Ste 150
Bolingbrook, IL 60440-2189

Mailing address

550 E Boughton Rd Ste 150
Bolingbrook, IL 60440-2189
Phone (630) 739-1791

Other names 1

  • Bolingbrook Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190515000729 IL Part B Supplier - Clinic/Group Practice 6103168505 Receives reassigned benefits from 6 practitioners
Practice locations: Bolingbrook, IL

National Provider Directory

National Provider Directory

Locations

550 E Boughton Rd
Ste 230
Bolingbrook, IL 60440
Phone (630) 739-1791

Practitioners & affiliated clinicians

Practitioners 8

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": "1552348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1205394970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E BOUGHTON RD STE 150",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402189",
            "telephone_number": "630-739-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E BOUGHTON RD STE 150",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402189",
            "telephone_number": "630-739-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUILL FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "QUILL",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-301-3043",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolingbrook Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.