Individual provider Active NPI

Arnetra Gilliam, D.C.

  • Chiropractor
  • Wheaton, IL
National Provider Identifier
1265479505
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
311 S Naperville Rd
Ste. C
Wheaton, IL 60187-5473
Phone
(630) 690-4040
Fax
(630) 690-4074
NPI assigned
Jun 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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

311 S Naperville Rd
Ste. C
Wheaton, IL 60187-5473

Mailing address

311 S Naperville Rd
Ste. C
Wheaton, IL 60187-5473
Phone (630) 690-4040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080225000091 IL Practitioner - Chiropractic 2668556069 Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

708 Church St
Evanston, IL 60201-3840
Phone (847) 224-3219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Russeau Team Healthcare, LTD. PastSince Jul 1, 1998 Accepting new patients
Wheaton Healthcare, LLC PastSince Apr 7, 2018 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265479505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S NAPERVILLE RD",
            "address_2": "STE. C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875473",
            "telephone_number": "630-690-4040",
            "fax_number": "630-690-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S NAPERVILLE RD",
            "address_2": "STE. C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875473",
            "telephone_number": "630-690-4040",
            "fax_number": "630-690-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "ARNETRA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "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 Wheaton, 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.
  • 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.