Individual provider Active NPI

Victoria Gazdacka, DC

  • Chiropractor
  • Elmhurst, IL
National Provider Identifier
1619314010
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012446 Issued in IL
Practice address
475 S Spring Rd
Elmhurst, IL 60126-3857
Phone
(630) 530-4744
NPI assigned
May 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012446 IL Primary

Addresses

Primary practice location

475 S Spring Rd
Elmhurst, IL 60126-3857

Mailing address

475 S Spring Rd
Elmhurst, IL 60126-3857
Phone (630) 530-4744

Other identifiers 1

IdentifierTypeStateIssuer
F400121928OtherILMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140228000779 IL Practitioner - Chiropractic 6002046562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Verdant Health SCGroup PAC ID 6800182023, 2 clinicians

Practice addresses (Care Compare)

475 S Spring Rd
Elmhurst, IL 60126-3857
Phone (630) 530-4744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012446ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Verdant Health SC Chiropractor CurrentSince Jul 23, 2016 Accepting new patients
Elm Chiropractic Fitness Clinic Chiropractor CurrentSince Jul 23, 2016 Accepting new patients
Halcyon Health Chiropractic, S.C. Chiropractor Past Accepting new patients

Locations

120 N York St
Ste 100
Elmhurst, IL 60126
Phone (630) 297-1464

475 S Spring Rd
Elmhurst, IL 60126
Phone (630) 530-4744

Organizations & group practices 3

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": "1369612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1619314010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 S SPRING RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263857",
            "telephone_number": "630-530-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S SPRING RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263857",
            "telephone_number": "630-530-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZDACKA",
        "first_name": "VICTORIA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-27",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400121928",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.