Individual provider Active NPI

Michael J Gontarek, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1467917856
Registry record updated Feb 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013326 Issued in IL
Practice address
1500 N Halsted St
Chicago, IL 60642-2517
Phone
(312) 787-7850
NPI assigned
Feb 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013326 IL Primary

Addresses

Primary practice location

1500 N Halsted St
Chicago, IL 60642-2517

Mailing address

1500 N Halsted St
Chicago, IL 60642-2517
Phone (312) 787-7850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013326ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Flow Life LLC CurrentSince Sep 5, 2023 Accepting new patients
Principle Performance, Inc CurrentSince Aug 28, 2022 Accepting new patients

Locations

200 Howard Ave
Ste 230
Des Plaines, IL 60018
Phone (224) 725-3151

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": "1549756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549756800000",
    "number": "1467917856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422517",
            "telephone_number": "312-787-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422517",
            "telephone_number": "312-787-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONTAREK",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-10",
        "last_updated": "2019-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.