Individual provider Active NPI

Leo Gerdov, D.C.

  • Chiropractor
  • Palatine, IL
National Provider Identifier
1366760308
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011689 Issued in IL
Practice address
1240 W Northwest Hwy
Palatine, IL 60067-1897
Phone
(773) 592-7227
Fax
(630) 216-1126
NPI assigned
May 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 038011689 IL Primary

Addresses

Primary practice location

1240 W Northwest Hwy
Palatine, IL 60067-1897

Mailing address

402 Wentworth Cir
Cary, IL 60013-2321
Phone (630) 988-5364

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101029001181 IL Practitioner - Chiropractic 7810181245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lotus Wellness Center PCGroup PAC ID 8921375908, 7 clinicians

Practice addresses (Care Compare)

1240 W Northwest Hwy
Palatine, IL 60067-1897
Phone (773) 592-7227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lotus Wellness Center P.C. Chiropractor CurrentSince Apr 3, 2017 Accepting new patients
Aleksandr Dekhtyar MD SC Past Accepting new patients
Dupage Healthcare LTD Chiropractor PastSince Mar 4, 2013 Accepting new patients

Locations

1292 W Northwest Hwy
Palatine, IL 60067
Phone (630) 988-5364

1240 W Northwest Hwy
Palatine, IL 60067
Phone (773) 592-7227

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": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1366760308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 WENTWORTH CIR",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600132321",
            "telephone_number": "630-988-5364",
            "fax_number": "630-216-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 W NORTHWEST HWY",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600671897",
            "telephone_number": "773-592-7227",
            "fax_number": "630-216-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDOV",
        "first_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-14",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.