Individual provider Active NPI

Eliud Miguel Sierra Jr., DC

  • Chiropractor
  • Bloomingdale, IL
National Provider Identifier
1396419552
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013740 Issued in IL
Practice address
148 S Bloomingdale Rd Ste 107C
Bloomingdale, IL 60108-1491
Phone
(630) 877-7389
Fax
(630) 982-1278
NPI assigned
Aug 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013740 IL Primary

Addresses

Primary practice location

148 S Bloomingdale Rd Ste 107C
Bloomingdale, IL 60108-1491

Mailing address

345 Shawnee Dr
Carol Stream, IL 60188-1966
Phone (630) 877-7389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211025002462 IL Practitioner - Chiropractic 1658769682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Global Rehabilitation Clinic, SCGroup PAC ID 3476513672, 7 clinicians

Practice addresses (Care Compare)

8565 W Dempster St
Niles, IL 60714-1472
Phone (847) 299-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Chiro Eliud M Sierra Jr Sole MBR Chiropractor CurrentSince Nov 1, 2023 Accepting new patients

Locations

148 S Bloomingdale Rd
Ste 107C
Bloomingdale, IL 60108
Phone (630) 877-7389

Organizations & group practices 2

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1396419552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SHAWNEE DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881966",
            "telephone_number": "630-877-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S BLOOMINGDALE RD STE 107C",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081491",
            "telephone_number": "630-877-7389",
            "fax_number": "630-982-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "ELIUD",
        "middle_name": "MIGUEL",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.