Individual provider Active NPI

Charles Michael Landgrebe, D.C.

  • Chiropractor
  • Tinley Park, IL
National Provider Identifier
1427227776
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
6828 171St St
Suite B
Tinley Park, IL 60477-3724
Phone
(269) 861-1789
NPI assigned
Feb 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

6828 171St St
Suite B
Tinley Park, IL 60477-3724

Mailing address

6828 171St St
Suite B
Tinley Park, IL 60477-3724
Phone (269) 861-1789

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080508000500 IL Practitioner - Chiropractic 1759460215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6828 171St St
Suite B
Tinley Park, IL 60477-3724
Phone (708) 429-4332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011128ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Landgrebe Chiropractic P.C. CurrentSince Feb 27, 2008 Accepting new patients

Locations

6828 171st St
#B
Tinley Park, IL 60477

6828 171st St
Ste B
Tinley Park, IL 60477
Phone (269) 861-1789

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": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1427227776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6828 171ST ST",
            "address_2": "SUITE B",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773724",
            "telephone_number": "269-861-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6828 171ST ST",
            "address_2": "SUITE B",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773724",
            "telephone_number": "269-861-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGREBE",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.