Active NPI
Carlos A Garavito, D.C., P.T.A.
- Chiropractor
- Berwyn, IL
National Provider Identifier
1346400587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.012462
- Practice address
- 2223 Oak Park Ave
Berwyn, IL 60402-4670 - Phone
- (708) 231-0012
- NPI assigned
- Jun 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160.004156 | IL | |
| Chiropractor | 111N00000X | 038.012462 | IL | Primary |
Addresses
Primary practice location
2223 Oak Park Ave
Berwyn, IL 60402-4670
Mailing address
2223 Oak Park Ave
Berwyn, IL 60402-4670
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.012462 | IL | MD | Chiropractor |
| 160.004156 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470960000000",
"number": "1346400587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2223 OAK PARK AVE",
"city": "BERWYN",
"state": "IL",
"postal_code": "604024670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2223 OAK PARK AVE",
"city": "BERWYN",
"state": "IL",
"postal_code": "604024670",
"telephone_number": "708-231-0012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARAVITO",
"first_name": "CARLOS",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.C., P.T.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-11",
"last_updated": "2016-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.004156",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.012462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.