Organization Active NPI

Platinum Chiropractic P.C.

  • Chiropractor
  • Oak Lawn, IL
National Provider Identifier
1477615185
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PLATINUM CHIROPRACTIC P.C.
Practice address
4615 W 103Rd St
Oak Lawn, IL 60453-4718
Phone
(708) 601-7679
NPI assigned
Dec 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rory J. Marrello, D.C.NPI 1952463093
Title
President
Phone
(708) 448-3624

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X IL Primary

Addresses

Primary practice location

4615 W 103Rd St
Oak Lawn, IL 60453-4718

Mailing address

7003 W 114TH PL
Worth, IL 60482-2042
Phone (708) 448-3624

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070228000187 IL Part B Supplier - Clinic/Group Practice 4688776230 Receives reassigned benefits from 1 practitioner
Practice locations: Palos Heights, IL

National Provider Directory

National Provider Directory

Locations

11008 S Cicero Ave
Oak Lawn, IL 60453
Phone (708) 423-8850

7207 W College Dr
Palos Heights, IL 60463
Phone (708) 261-6867

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477615185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7003 W 114TH PL",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604822042",
            "telephone_number": "708-448-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 W 103RD ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534718",
            "telephone_number": "708-601-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARRELLO",
        "authorized_official_first_name": "RORY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-448-3624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.