Individual provider Active NPI

Franklin Michael Bodnar, D.C.

  • Chiropractor
  • St Charles, IL
National Provider Identifier
1982921367
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011669 Issued in IL
Practice address
302 S 14TH St
St Charles, IL 60174-2511
Phone
(630) 513-7770
NPI assigned
Apr 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4661012 WI
Chiropractor 111N00000X 038011669 IL Primary

Addresses

Primary practice location

302 S 14TH St
St Charles, IL 60174-2511

Mailing address

302 S 14TH St
St Charles, IL 60174-2511
Phone (630) 513-7770

Other identifiers 1

IdentifierTypeStateIssuer
1982921367MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
038011669ILMDChiropractor
4661012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Pain and Wellness Center, LLC Chiropractor CurrentSince Sep 29, 2019 Accepting new patients
Lakeview Chiropractic and Wellness Clinic, S.C. PastSince Jun 9, 2023 Accepting new patients
Nyuli Chiropractic, P.C. Chiropractor PastSince Sep 29, 2019 Accepting new patients

Locations

302 S 14th St
St Charles, IL 60174
Phone (630) 513-7770

Organizations & group practices 3

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": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1982921367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S 14TH ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742511",
            "telephone_number": "630-513-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S 14TH ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742511",
            "telephone_number": "630-513-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "FRANKLIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4661012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982921367",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.