Individual provider Active NPI

Ryan Jon Gawron, D.C

  • Chiropractor
  • Palos Heights, IL
National Provider Identifier
1972906832
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012701 Issued in IL
Practice address
12211 S Harlem Ave Ste 1S
Palos Heights, IL 60463-1471
Phone
(708) 671-8082
Fax
(708) 777-4764
NPI assigned
Oct 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012701 IL Primary

Addresses

Primary practice location

12211 S Harlem Ave Ste 1S
Palos Heights, IL 60463-1471

Mailing address

12211 S Harlem Ave Ste 1S
Palos Heights, IL 60463-1471
Phone (708) 671-8082

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1972906832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12211 S HARLEM AVE STE 1S",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631471",
            "telephone_number": "708-671-8082",
            "fax_number": "708-777-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12211 S HARLEM AVE STE 1S",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631471",
            "telephone_number": "708-671-8082",
            "fax_number": "708-777-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWRON",
        "first_name": "RYAN",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-06",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.