JERRY BRIAN JR. VINCENT (DC) – Chiropractor, NPI 1215786835

JERRY BRIAN JR. VINCENT (DC) is a healthcare provider. based in Wood dale, Illinois. specializing in CHIROPRACTIC. They hold the professional credentials DC. They hold a License No. 038.014151 (IL). The NPI Number for JERRY BRIAN JR. VINCENT (DC) is 1215786835

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
JERRY BRIAN JR. VINCENT (DC)
NPI
1215786835
Phone
(630) 766-1552
Address
199 S ADDISON RD STE 106
Enumeration Date
15 May 2024
Last Update Date
16 May 2024

Doctor Profile

Medical School Name
LIFE CHIROPRACTIC COLLEGE
Secondary Phone
63076615522
Graduation Year
2024 (2 years ago)
PAC ID
4688116841
Group Practice PAC ID
6204092539
Professional Enrollment ID
I20240604001684
Address ID
IL601911929WO199XXRDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

2,145 CHIROPRACTIC in IL

Provider Addresses for JERRY BRIAN JR. VINCENT (DC)

  • 199 S ADDISON RD STE 106

    WOOD DALE, IL 601911978

    Phone: (630) 766-1552

    Type: Location

  • 780 E IRVING PARK RD STE 2W

    ROSELLE, IL 601724343

    Phone: (706) 728-5109

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240604001684IChiropracticILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60191)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204092539View full group profile
NameSpecialtyState
C H I R O P R A C T I CIL
C H I R O P R A C T I CIL
Physical Therapist In Private PracticeIL

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Frequently asked questions

How do I look up JERRY BRIAN JR. VINCENT (DC) by NPI?
Use NPI 1215786835 when you need to reference JERRY BRIAN JR. VINCENT (DC) in forms, claims, or directories.
Is JERRY BRIAN JR. VINCENT (DC)'s NPI currently valid?
The extract we use shows JERRY BRIAN JR. VINCENT (DC) as active.
What kind of provider is JERRY BRIAN JR. VINCENT (DC)?
The page reflects Chiropractor for JERRY BRIAN JR. VINCENT (DC). Clinical services aligned with this taxonomy classification.
Does JERRY BRIAN JR. VINCENT (DC) practice in Illinois?
You will see Wood Dale, Illinois on file for JERRY BRIAN JR. VINCENT (DC) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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