Active NPI
Grant Charles Iannelli, DC
- Internist Chiropractor
- Lombard, IL
National Provider Identifier
1538298419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- License
- 038005170
- Practice address
- 543 S Finley Rd
Lombard, IL 60148-2430 - Phone
- (630) 640-5706
- Fax
- (630) 477-0303
- NPI assigned
- Mar 5, 2007
- Last updated
- May 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 038005170 | IL | Primary |
Addresses
Primary practice location
543 S Finley Rd
Lombard, IL 60148-2430
Mailing address
543 S Finley Rd
Lombard, IL 60148-2430
Phone (630) 640-5706
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
| License | State | Type | Specialty |
|---|---|---|---|
| 038005170 | IL | MD | Internist Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368230400000",
"number": "1538298419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "543 S FINLEY RD",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601482430",
"telephone_number": "630-640-5706",
"fax_number": "630-477-0303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "543 S FINLEY RD",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601482430",
"telephone_number": "630-640-5706",
"fax_number": "630-477-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IANNELLI",
"first_name": "GRANT",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2013-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "IL",
"license": "038005170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.