NPIMap

Organization Active NPI

J Revello Chiropractic SC

  • Chiropractor
  • Crestwood, IL
National Provider Identifier
1326484874
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.010310 Issued in IL
Legal business name
J REVELLO CHIROPRACTIC SC
Practice address
13703 Cicero Ave
Crestwood, IL 60445-1824
Phone
(708) 385-4416
Fax
(708) 388-8825
NPI assigned
May 10, 2013
Last updated
May 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Authorized official

Name
John Revello
Title
Chiropractor
Phone
(708) 385-4416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038.010310 IL Primary

Addresses

Primary practice location

13703 Cicero Ave
Crestwood, IL 60445-1824

Mailing address

13703 Cicero Ave
Crestwood, IL 60445-1824
Phone (708) 385-4416

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1326484874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13703 CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451824",
            "telephone_number": "708-385-4416",
            "fax_number": "708-388-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13703 CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451824",
            "telephone_number": "708-385-4416",
            "fax_number": "708-388-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J REVELLO CHIROPRACTIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "REVELLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "708-385-4416"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.010310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.