Individual provider Active NPI

John G. Goodfellow III, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1235131608
Registry record updated Jan 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-008453 Issued in IL
Practice address
6630 W Higgins Ave
Chicago, IL 60656-2138
Phone
(773) 237-5757
Fax
(773) 840-2502
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-008453 IL Primary

Addresses

Primary practice location

6630 W Higgins Ave
Chicago, IL 60656-2138

Mailing address

6630 W Higgins Ave
Chicago, IL 60656-2138
Phone (773) 237-5757

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008453ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Goodfellow Chiropractic PC Chiropractor CurrentSince Mar 1, 2011 Accepting new patients
Foot Care Consultants 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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356998400000",
    "number": "1235131608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606562138",
            "telephone_number": "773-237-5757",
            "fax_number": "773-840-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606562138",
            "telephone_number": "773-237-5757",
            "fax_number": "773-840-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODFELLOW",
        "first_name": "JOHN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008453",
            "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 Jan 1, 2013; 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.