Carly M. Smith, D.C.
Individual provider Active NPI Chiropractor · Elmwood PK, IL
NPI 1821265760 · NPPES record last updated Nov 12, 2008
Key facts
- NPI
- 1821265760
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038-011174 (IL)
- Practice address
- 7716 W. North
Elmwood PK, IL 60707 - Phone
- (708) 456-8844
- Fax
- (708) 456-5550
- NPI assigned
- May 9, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Smith Chiropractic Health Care, SC
Practice addresses (Care Compare)
7716 W N Ave
Elmwood Park, IL 60707-4123
Phone (708) 456-8844
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081030000597 | IL | Practitioner - Chiropractic | 7214096684 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-011174 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smith Chiropractic Health Care, SC | Chiropractor | Current |
Accepting new patients |
Locations
7716 W North Ave
Elmwood Park, IL 60707
Phone (708) 456-8844
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-011174 | IL | Yes |
Addresses
Primary practice location
7716 W. North
Elmwood PK, IL 60707
Mailing address
7716 W. North Ave
Elmwood PK, IL 60707
Phone (708) 456-8844
Other names
- Carly M. Zilligen
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.