Individual provider Active NPI

Gina M. Moskalik, D.C.

  • Chiropractor
  • Cary, IL
National Provider Identifier
1396986105
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011326 Issued in IL
Practice address
716 Laurel LN
Cary, IL 60013-3205
Phone
(847) 658-6066
Fax
(866) 837-6099
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 038011326 IL
Rehabilitation Chiropractor 111NR0400X 038011326 IL
Chiropractor 111N00000X 038.011326 IL Primary

Addresses

Primary practice location

716 Laurel LN
Cary, IL 60013-3205

Mailing address

PO Box 453
Cary, IL 60013-0453
Phone (847) 658-6066

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180612003086 IL Practitioner - Chiropractic 2769737923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

716 Laurel LN
Cary, IL 60013-3205
Phone (847) 658-6066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011326ILMDChiropractor
038011326ILMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vibrance Chiropractic & Wellness Center, LTD Chiropractor CurrentSince Jun 21, 2019 Accepting new patients

Organizations & group practices 1

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": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1396986105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 453",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600130453",
            "telephone_number": "847-658-6066",
            "fax_number": "866-837-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 LAUREL LN",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600133205",
            "telephone_number": "847-658-6066",
            "fax_number": "866-837-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKALIK",
        "first_name": "GINA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": "038011326",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038011326",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.