Dr. Brian McGuckin Laboratory Nutrition, PLLC

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

Legal business name

DR. BRIAN MCGUCKIN LABORATORY NUTRITION, PLLC

Practice address

15 Oak St Ste 2a
Frankfort, IL 60423-1486

Phone

(779) 324-5741

Fax

(779) 324-5607

NPI assigned

Sep 11, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Brian Charles McGuckin, DCNPI 1821028937

Title

Manager Owner of PLLC

Phone

(779) 324-5741

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Charles McGuckin, D.C.

  • Internist Chiropractor
  • Valparaiso, IN
  • NPI 1821028937

  IL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1992531487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21200 S LA GRANGE RD STE 189",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604232003",
            "telephone_number": "779-324-5741",
            "fax_number": "779-324-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OAK ST STE 2A",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231486",
            "telephone_number": "779-324-5741",
            "fax_number": "779-324-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRIAN MCGUCKIN LABORATORY NUTRITION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "MCGUCKIN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER OWNER OF PLLC",
        "authorized_official_telephone_number": "779-324-5741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Internist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internist Chiropractor in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Internist Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.