Beau Blakeley, DC

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

038013267 Issued in IL

Practice address

320 W Burlington Ave
La Grange, IL 60525-2363

Phone

(708) 497-2441

NPI assigned

Oct 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Suvarna Chiropractic Inc.

  • Chiropractor
  • Chicago, IL
  • NPI 1255889317
  Medicare reassignment NPD

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639644222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W BURLINGTON AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252363",
            "telephone_number": "708-497-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W BURLINGTON AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252363",
            "telephone_number": "708-497-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELEY",
        "first_name": "BEAU",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038013267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fanor Benavidez
• Ian Bennett
• Ellie Benz, RBT
• BFB Therapeutics, LLC
• Tina Biel, ED.S, NCSP
• Debra Babb Blakely, RN, LCPC
• Demetrios Bobolos, LAC
• Samantha Marie Boburka, PA-C
• Jerry P Bonet, D.P.M.
• Tracy Bongiorno, P.A.-C

• Neurology Chiropractor in La Grange, IL
• Providers in La Grange, IL by specialty
• Neurology Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.