Individual provider Active NPI

Robert M Petty, D.C.

  • Chiropractor
  • Hanover Park, IL
National Provider Identifier
1225119092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
6602 Barrington Rd
Suite C
Hanover Park, IL 60133-3900
Phone
(630) 483-7246
Fax
(630) 483-7258
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

6602 Barrington Rd
Suite C
Hanover Park, IL 60133-3900

Mailing address

6602 Barrington Rd
Suite C
Hanover Park, IL 60133-3900
Phone (630) 483-7246

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
038007204ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Muller Chiropractic PLLC Chiropractor PastSince Aug 22, 2024 Accepting new patients
Harris Chiropractic, Inc Chiropractor Past Accepting new patients

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225119092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6602 BARRINGTON RD",
            "address_2": "SUITE C",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601333900",
            "telephone_number": "630-483-7246",
            "fax_number": "630-483-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6602 BARRINGTON RD",
            "address_2": "SUITE C",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601333900",
            "telephone_number": "630-483-7246",
            "fax_number": "630-483-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.