Glen John Nisivoccia, D C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038004843 Issued in IL

Practice address

19600 La Grange Rd
Mokena, IL 60448-9321

Phone

(708) 478-3000

Fax

(708) 478-3007

NPI assigned

Aug 9, 2006

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

Specialty

Chiropractic

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Frankfort Spinal Rehabilitation and Physical Therapy IncGroup PAC ID 8729050489, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Frankfort Spinal Rehabilitation & Physical Therapy Inc

  • Orthopedic Chiropractor
  • Mokena, IL
  • NPI 1578510905
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1689684979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13129 HIDDEN VALLEY DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918486",
            "telephone_number": "708-301-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489321",
            "telephone_number": "708-478-3000",
            "fax_number": "708-478-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISIVOCCIA",
        "first_name": "GLEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip David Narcissi, DPM
• Stephanie Nash, LCSW
• Carlos Alberto Natera Garcia, SA-C
• New Normal Psychiatry & Wellness PLLC
• Adrian Nica, M.D.
• Juan Noguera, RSA
• Thomas R Norberg, D.C.
• Northern Light Counseling & Consultation LLC
• Northwestern Medical Faculty Foundation
• Philomena Bridget Nowak, MS LCPC CRC

• Chiropractor in Mokena, IL
• Providers in Mokena, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.