Active NPI
Gary L Lavell, D.C.
- Chiropractor
- Elgin, IL
National Provider Identifier
1962626408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Practice address
- 1750 Grandstand PL
Elgin, IL 60123-4900 - Phone
- (847) 931-8113
- Fax
- (847) 931-8113
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
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
1750 Grandstand PL
Elgin, IL 60123-4900
Mailing address
356 N Airlite St
Elgin, IL 60123-4971
Phone (847) 931-8113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04582084 | Other | IL | BLUE SHIELD PROVIDER NO. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-004985 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1962626408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "356 N AIRLITE ST",
"city": "ELGIN",
"state": "IL",
"postal_code": "601234971",
"telephone_number": "847-931-8113",
"fax_number": "847-931-8113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 GRANDSTAND PL",
"city": "ELGIN",
"state": "IL",
"postal_code": "601234900",
"telephone_number": "847-931-8113",
"fax_number": "847-931-8113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVELL",
"first_name": "GARY",
"middle_name": "L",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER NO.",
"identifier": "04582084",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.