Individual provider Active NPI

George Eugene Radice, DC

  • Chiropractor
  • Carol Stream, IL
National Provider Identifier
1407914534
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38005860 Issued in IL
Practice address
166 N Gary Ave
Carol Stream, IL 60188
Phone
(630) 414-3606
Fax
(630) 665-5656
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38005860 IL Primary

Addresses

Primary practice location

166 N Gary Ave
Carol Stream, IL 60188

Mailing address

166 N Gary Ave
Carol Stream, IL 60188
Phone (630) 414-3606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031208000703 IL Practitioner - Chiropractic 0446156822 Practice locations: Carol Stream, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

166 N Gary Ave
Carol Stream, IL 60188-2093
Phone (606) 665-5656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38005860ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericks Chiropractic Center, LTD. Chiropractor Past 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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1407914534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "60188",
            "telephone_number": "630-414-3606",
            "fax_number": "630-665-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "60188",
            "telephone_number": "630-414-3606",
            "fax_number": "630-665-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADICE",
        "first_name": "GEORGE",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38005860",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 11, 2018; 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.