Individual provider Active NPI

Ryan Friel, D.C.

  • Chiropractor
  • Sycamore, IL
National Provider Identifier
1871952473
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013481 Issued in IL
Practice address
2535 Bethany Rd Ste 100
Sycamore, IL 60178-3126
Phone
(815) 517-0826
NPI assigned
Feb 11, 2016
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IN PROCESS AL
Chiropractor 111N00000X 038013481 IL Primary

Addresses

Primary practice location

2535 Bethany Rd Ste 100
Sycamore, IL 60178-3126

Mailing address

PO Box 21157
Huntsville, AL 35813-5157
Phone (256) 519-3550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200417000955 IL Practitioner - Chiropractic 0143529156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2535 Bethany Rd
Suite 100
Sycamore, IL 60178-3126
Phone (815) 517-0826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IN PROCESSALMDChiropractor
038013481ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Chiropractic & Laser Center, LLC CurrentSince Mar 12, 2020 Accepting new patients

Locations

2535 Bethany Rd
Ste 100
Sycamore, IL 60178
Phone (815) 517-0826

Organizations & group practices 1

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": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1871952473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21157",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358135157",
            "telephone_number": "256-519-3550",
            "fax_number": "256-513-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 BETHANY RD STE 100",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783126",
            "telephone_number": "815-517-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEL",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "IN PROCESS",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.