Individual provider Active NPI

Michelle McPolin Boyd, D.C.

  • Chiropractor
  • La Grange Park, IL
National Provider Identifier
1790806461
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38009671 Issued in IL
Practice address
355 N la Grange Rd
La Grange Park, IL 60526-5622
Phone
(708) 588-8270
Fax
(708) 588-8271
NPI assigned
Apr 2, 2007
Last updated
Jun 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38009671 IL Primary

Addresses

Primary practice location

355 N la Grange Rd
La Grange Park, IL 60526-5622

Mailing address

355 N la Grange Rd
La Grange Park, IL 60526-5622
Phone (708) 588-8270

Other identifiers 1

IdentifierTypeStateIssuer
01632424OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050701000280 IL Practitioner - Chiropractic 3375587496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Balance Chiropractic and Acupuncture Center LTDGroup PAC ID 9739123845, 3 clinicians

Practice addresses (Care Compare)

518 Hillgrove Ave
Suite 275
Western Springs, IL 60558-1460
Phone (708) 588-8270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38009671ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Balance Chiropractic & Acupuncture Center, LTD. Chiropractor CurrentSince May 28, 2002 Accepting new patients
Margaret E Brownlie DC PC Chiropractor Past Accepting new patients

Locations

18 W 1st St
Ste 2
Hinsdale, IL 60521
Phone (630) 455-5885

355 N La Grange Rd
La Grange Pk, IL 60526
Phone (708) 588-8270

440 Sherwood Rd
La Grange Pk, IL 60526
Phone (708) 579-1003

518 Hillgrove Ave
Ste 275
Western Springs, IL 60558
Phone (708) 588-8270

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1790806461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 N LA GRANGE RD",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605265622",
            "telephone_number": "708-588-8270",
            "fax_number": "708-588-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 N LA GRANGE RD",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605265622",
            "telephone_number": "708-588-8270",
            "fax_number": "708-588-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "MICHELLE",
        "middle_name": "MCPOLIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38009671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01632424",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.