Individual provider Active NPI

Ryan G Loucks, DC

  • Chiropractor
  • Glen Carbon, IL
National Provider Identifier
1770440323
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.014410 Issued in IL
Practice address
62 Brenda St
Glen Carbon, IL 62034-1938
Phone
(618) 580-8619
NPI assigned
Jan 6, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.014410 IL Primary

Addresses

Primary practice location

62 Brenda St
Glen Carbon, IL 62034-1938

Mailing address

62 Brenda St
Glen Carbon, IL 62034-1938
Phone (618) 580-8619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260513002577 IL Practitioner - Chiropractic 5698244242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

304 -B Bargraves Boulevard
Troy, IL 62294
Phone (618) 917-1003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.014410ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Palms Health Center PLLC Chiropractor CurrentSince Apr 4, 2026 Accepting new patients

Locations

304 Bargraves Blvd
Unit B
Troy, IL 62294

Organizations & group practices 1

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": "1767657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1770440323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BRENDA ST",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341938",
            "telephone_number": "618-580-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BRENDA ST",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341938",
            "telephone_number": "618-580-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUCKS",
        "first_name": "RYAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-06",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.014410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.