Individual provider Active NPI

Michael Edward McGovern, D.C.

  • Chiropractor
  • South Elgin, IL
National Provider Identifier
1336365030
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010766 Issued in IL
Practice address
382 Randall Rd
South Elgin, IL 60177-3318
Phone
(224) 276-6633
NPI assigned
Apr 18, 2007
Last updated
Apr 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010766 IL Primary

Addresses

Primary practice location

382 Randall Rd
South Elgin, IL 60177-3318

Mailing address

2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240702001542 ID Practitioner - Chiropractic 6204936685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlimited Health ChiropracticGroup PAC ID 7315071339, 17 clinicians

Practice addresses (Care Compare)

320 E Neider Ave
Suite 103
Coeur D Alene, ID 83815-6007
Phone (208) 930-4944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14721TXMDAddiction (Substance Use Disorder) Counselor
038-010766ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Unlimited Health Chiropractic Chiropractor CurrentSince Apr 6, 2024 Accepting new patients
Unlimited Health Chiropractic PastSince Apr 19, 2020 Accepting new patients
Peak Physical Medicine and Wellness PLLC PastSince Aug 25, 2024 Accepting new patients
Mind Body Spirit Service Corp Past Accepting new patients
Strelcheck Chiropractic Clinic LTD Chiropractor PastSince Dec 29, 2005 Accepting new patients

Locations

320 E Neider Ave
Ste 103
Coeur D Alene, ID 83815
Phone (208) 930-4944

320 E Neider Ave
Ste 105
Coeur D Alene, ID 83815
Phone (208) 930-0045

3145 E Mullan Ave
Ste 500
Post Falls, ID 83854
Phone (208) 981-0129

Organizations & group practices 5

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1336365030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 RANDALL RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773318",
            "telephone_number": "224-276-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.