Individual provider Active NPI

Allan Kirchner-Gomez, D.C.

  • Chiropractor
  • Carol Stream, IL
National Provider Identifier
1346303146
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009776 Issued in IL
Practice address
798 W Army Trail Rd
Carol Stream, IL 60188-9297
Phone
(630) 233-8343
Fax
(630) 233-8346
NPI assigned
Dec 19, 2006
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038009776 IL Primary

Addresses

Primary practice location

798 W Army Trail Rd
Carol Stream, IL 60188-9297

Mailing address

798 W Army Trail Rd
Carol Stream, IL 60188-9297
Phone (630) 233-8343

Other identifiers 1

IdentifierTypeStateIssuer
038009776MedicaidIL

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
038009776ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Core Wellness Chiropractic and Anti-Aging Centre Chiropractor Past Accepting new patients
West Suburban Healthcare Center LLC Chiropractor PastSince Jul 27, 2010 Accepting new patients

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, 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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1346303146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 W ARMY TRAIL RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601889297",
            "telephone_number": "630-233-8343",
            "fax_number": "630-233-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 W ARMY TRAIL RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601889297",
            "telephone_number": "630-233-8343",
            "fax_number": "630-233-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHNER-GOMEZ",
        "first_name": "ALLAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009776",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.