Organization Active NPI

Rehab Chiro Eliud M Sierra Jr Sole MBR

  • Chiropractor
  • Bloomingdale, IL
National Provider Identifier
1861279390
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
REHAB CHIRO ELIUD M SIERRA JR SOLE MBR
Practice address
148 S Bloomingdale Rd Ste 107C
Bloomingdale, IL 60108-1491
Phone
(630) 877-7389
Fax
(630) 982-1278
NPI assigned
Sep 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Dr. Eliud Miguel Sierra Jr., DCNPI 1396419552
Title
Chiropractic Physician
Phone
(630) 877-7389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

148 S Bloomingdale Rd Ste 107C
Bloomingdale, IL 60108-1491

Mailing address

345 Shawnee Dr
Carol Stream, IL 60188-1966
Phone (630) 877-7389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240117000185 IL Part B Supplier - Clinic/Group Practice 4082066915 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomingdale, IL

National Provider Directory

National Provider Directory

Locations

148 S Bloomingdale Rd
Ste 107C
Bloomingdale, IL 60108
Phone (630) 877-7389

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1861279390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SHAWNEE DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881966",
            "telephone_number": "630-877-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S BLOOMINGDALE RD STE 107C",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081491",
            "telephone_number": "630-877-7389",
            "fax_number": "630-982-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB CHIRO ELIUD M SIERRA JR SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "SIERRA",
        "authorized_official_first_name": "ELIUD",
        "authorized_official_middle_name": "MIGUEL",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "630-877-7389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.

Verify at the official NPI Registry.