Individual provider Active NPI

Gregory Speedy Iavarone, DC

  • Chiropractor
  • Addison, IL
National Provider Identifier
1972591840
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008341 Issued in IL
Practice address
1250 W Lake St
17
Addison, IL 60101-5744
Phone
(630) 543-7246
Fax
(630) 907-9015
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038008341 IL Primary

Addresses

Primary practice location

1250 W Lake St
17
Addison, IL 60101-5744

Mailing address

1250 W Lake St
17
Addison, IL 60101-5744
Phone (630) 628-7881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040513001355 IL Practitioner - Chiropractic 6608866488 Practice locations: Addison, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1250 W Lake St
Suite 17
Addison, IL 60101-5744
Phone (630) 628-7881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Gregory Iavarone Chiropractor PastSince Jan 1, 1990 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1972591840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W LAKE ST",
            "address_2": "17",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015744",
            "telephone_number": "630-628-7881",
            "fax_number": "630-628-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W LAKE ST",
            "address_2": "17",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015744",
            "telephone_number": "630-543-7246",
            "fax_number": "630-907-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IAVARONE",
        "first_name": "GREGORY",
        "middle_name": "SPEEDY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.