Gabriel Griffith Ellis, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038011667 Issued in IL

Practice address

127 Capista Dr
Shorewood, IL 60404-8551

Phone

(815) 609-6150

Fax

(815) 774-0235

NPI assigned

May 13, 2010

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

Palmer College Chiropractic - Davenport, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactive Wellness GroupGroup PAC ID 8426407800, 2 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.

• Proactive Wellness Group

  • Nurse Practitioner
  • Shorewood, IL
  • NPI 1275213902

  Chiropractor

  Medicare reassignment Care Compare group NPD
• Community Chiropractic Corp.

  • Chiropractor
  • Shorewood, IL
  • NPI 1740274927
  NPD (past)

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1821316951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HEMPSTEAD PL",
            "address_2": "COMMUNITY CHIROPRACTIC CENTER",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604331745",
            "telephone_number": "815-774-9985",
            "fax_number": "815-774-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CAPISTA DR",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048551",
            "telephone_number": "815-609-6150",
            "fax_number": "815-774-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "GABRIEL",
        "middle_name": "GRIFFITH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-13",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• E Mediate Cure LLC
• E Mediate Cure LLC
• Patti-Ann Ebert, OTR
• Mena Edwards
• Ellis Chiropractic Inc.
• Jenna Ann Ewers, DC
• Faber Dental Arts
• Katherine Laine Kinney Faber, D.M.D.
• Feelings and Healings PLLC
• Filotto Speech Therapy

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.