Active NPI
Michael Joseph Gagnon, DC
- Chiropractor
- Oak Forest, IL
National Provider Identifier
1831267178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Practice address
- 6300 West 159TH St Suite a
Oak Forest, IL 60452-2779 - Phone
- (708) 535-9588
- Fax
- (708) 535-9589
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Primary |
Addresses
Primary practice location
6300 West 159TH St Suite a
Oak Forest, IL 60452-2779
Mailing address
6300 West 159TH St Suite a
Oak Forest, IL 60452-2779
Phone (708) 535-9588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080114000005 | IL | Practitioner - Chiropractic | 9234210568 | Practice locations: Oak Forest, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038005009 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831267178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6300 WEST 159TH ST SUITE A",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "604522779",
"telephone_number": "708-535-9588",
"fax_number": "708-535-9589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 WEST 159TH ST SUITE A",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "604522779",
"telephone_number": "708-535-9588",
"fax_number": "708-535-9589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNON",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.