Individual provider Active NPI

Arthur John Chatellier III, DC

  • Chiropractor
  • Dekalb, IL
National Provider Identifier
1649340720
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008193 Issued in IL
Practice address
650 N Peace Rd Ste C
Dekalb, IL 60115-8401
Phone
(815) 748-3102
Fax
(815) 748-7433
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1154 LA
Chiropractor 111N00000X A06057 IA
Chiropractor 111N00000X 038008193 IL Primary

Addresses

Primary practice location

650 N Peace Rd Ste C
Dekalb, IL 60115-8401

Mailing address

650 N Peace Rd Ste C
Dekalb, IL 60115-8401
Phone (815) 748-3102

Other identifiers 1

IdentifierTypeStateIssuer
038008193MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120626000616 IL Practitioner - Chiropractic 9335304203 Practice locations: Dekalb, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

650 N Peace Rd
Suite C
Dekalb, IL 60115-8401

650 N Peace Rd C
Dekalb, IL 60115-8401
Phone (815) 748-3102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A06057IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1649340720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N PEACE RD STE C",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601158401",
            "telephone_number": "815-748-3102",
            "fax_number": "815-748-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N PEACE RD STE C",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601158401",
            "telephone_number": "815-748-3102",
            "fax_number": "815-748-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATELLIER",
        "first_name": "ARTHUR",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1154",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06057",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038008193",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.