Individual provider Active NPI

Alec Pawlak, DC

  • Chiropractor
  • St Charles, IL
National Provider Identifier
1699544965
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.014089 Issued in IL
Practice address
923 S Randall Rd
Saint Charles, IL 60174-1556
Phone
(630) 517-5788
Fax
(630) 912-3702
NPI assigned
Dec 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.014089 IL Primary

Addresses

Primary practice location

923 S Randall Rd
Saint Charles, IL 60174-1556

Mailing address

1842 N Circle View LN
La Porte, IN 46350-2132
Phone (219) 363-1566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104002783 IL Practitioner - Chiropractic 1052844693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bodyworks Medical Center of Geneva PLLCGroup PAC ID 0345657284, 4 clinicians

Practice addresses (Care Compare)

923 S Randall Rd
Saint Charles, IL 60174-1556
Phone 239970248412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.014089ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bodyworks Medical Center of Geneva PLLC CurrentSince Aug 29, 2024 Accepting new patients
Minor Chiropractic Health Center PC Chiropractor PastSince Dec 1, 2023 Accepting new patients

Locations

923 S Randall Rd
St Charles, IL 60174
Phone (630) 517-5788

Organizations & group practices 2

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": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1699544965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 N CIRCLE VIEW LN",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463502132",
            "telephone_number": "219-363-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 S RANDALL RD",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601741556",
            "telephone_number": "630-517-5788",
            "fax_number": "630-912-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLAK",
        "first_name": "ALEC",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-27",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.014089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.