Individual provider Active NPI

Latoya Nashage Glass-Sherman, D.C.

  • Chiropractor
  • Country Club Hills, IL
National Provider Identifier
1326030461
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010238 Issued in IL
Practice address
4023 183Rd St
Country Club Hills, IL 60478-5306
Phone
(708) 799-7855
Fax
(708) 799-7866
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010238 IL Primary

Addresses

Primary practice location

4023 183Rd St
Country Club Hills, IL 60478-5306

Mailing address

4023 183Rd St
Country Club Hills, IL 60478-5306
Phone (708) 799-7855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110412000029 IL Practitioner - Chiropractic 2062696354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4023 183Rd St
Country Club Hills, IL 60478-5306
Phone (708) 799-7855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010238ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Miracles Revealed Chiropractic Wellness Center Chiropractor CurrentSince Dec 26, 2013 Accepting new patients
Miracles Revealed Chiropractic Wellness Center Chiropractor CurrentSince Dec 26, 2013 Accepting new patients
Health on Earth Chiropractic and Rehabilitation, LLC Chiropractor Past Accepting new patients

Locations

4023 183rd St
Country Club Hills, IL 60478
Phone (708) 799-7855

Organizations & group practices 3

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1326030461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 183RD ST",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785306",
            "telephone_number": "708-799-7855",
            "fax_number": "708-799-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 183RD ST",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785306",
            "telephone_number": "708-799-7855",
            "fax_number": "708-799-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS-SHERMAN",
        "first_name": "LATOYA",
        "middle_name": "NASHAGE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Country Club Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.