Individual provider Active NPI

Thomas Daniel Huyvaert, DC LAC

  • Chiropractor
  • Glendale Heights, IL
National Provider Identifier
1518971902
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038004730 Issued in IL
Practice address
1142 Main St
Glendale Heights, IL 60139-3506
Phone
(630) 790-0030
Fax
(630) 790-2086
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038004730 IL Primary
Acupuncturist 171100000X 198000187 IL

Addresses

Primary practice location

1142 Main St
Glendale Heights, IL 60139-3506

Mailing address

1142 Main St
Glendale Heights, IL 60139-3506
Phone (630) 790-0030

Other identifiers 1

IdentifierTypeStateIssuer
02215409OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080424000512 IL Practitioner - Chiropractic 7012095433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1142 N Main St
Glendale Heights, IL 60139-3506
Phone (630) 790-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038004730ILMDChiropractor
198000187ILMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Huyvaert Clinic of Chiropractic LTD Chiropractor CurrentSince Apr 1, 1990 Accepting new patients

Locations

1142 N Main St
Glendale Hts, IL 60139
Phone (630) 790-0030

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1518971902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 MAIN ST",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601393506",
            "telephone_number": "630-790-0030",
            "fax_number": "630-790-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 MAIN ST",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601393506",
            "telephone_number": "630-790-0030",
            "fax_number": "630-790-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYVAERT",
        "first_name": "THOMAS",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DC LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004730",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198000187",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02215409",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.