Individual provider Active NPI

Boris Veller, DC

  • Chiropractor
  • Mundelein, IL
National Provider Identifier
1851443329
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010408 Issued in IL
Practice address
333 E Il Route 83 Ste B5
Mundelein, IL 60060-4299
Phone
(224) 432-7226
NPI assigned
Jan 17, 2007
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 011309 NY
Chiropractor 111N00000X 038010408 IL Primary

Addresses

Primary practice location

333 E Il Route 83 Ste B5
Mundelein, IL 60060-4299

Mailing address

333 E Il Route 83 Ste B5
Mundelein, IL 60060-4299
Phone (224) 432-7226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150629001014 IL Practitioner - Chiropractic 2264536101 Reassigns benefits to 1 organization
Practice locations: Mundelein, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

333 E Il Route 83
Suite B5
Mundelein, IL 60060-4299
Phone (224) 432-7226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011309NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic4You, S.C. Chiropractor CurrentSince Sep 21, 2022 Accepting new patients
Back and Neck Relief Center of Il Inc. Chiropractor CurrentSince Jul 24, 2022 Accepting new patients

Locations

333 E State Route 83
Ste B5
Mundelein, IL 60060
Phone (224) 432-7226

1500 Shermer Rd
Ste 1SE
Northbrook, IL 60062
Phone (224) 415-3707

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1851443329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83 STE B5",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604299",
            "telephone_number": "224-432-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83 STE B5",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604299",
            "telephone_number": "224-432-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLER",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011309",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.