DR. GLEN JOHN NISIVOCCIA (D C) – Chiropractor, NPI 1689684979

DR. GLEN JOHN NISIVOCCIA (D C) is a healthcare provider. based in Mokena, Illinois. specializing in CHIROPRACTIC. They hold the professional credentials D C. They hold a License No. 038004843 (IL). The NPI Number for DR. GLEN JOHN NISIVOCCIA (D C) is 1689684979

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. GLEN JOHN NISIVOCCIA (D C)
NPI
1689684979
Phone
(708) 478-3000
Address
19600 LA GRANGE RD
Enumeration Date
9 August 2006
Last Update Date
17 June 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7084783000
Graduation Year
1985 (41 years ago)
PAC ID
8426020181
Group Practice PAC ID
8729050489
Professional Enrollment ID
I20051213000162
Address ID
IL604489321MO19600RDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,145 CHIROPRACTIC in IL

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Provider Addresses for DR. GLEN JOHN NISIVOCCIA (D C)

  • 19600, South La Grange Road, Mokena, Will County, Illinois, 60448, United States

    MOKENA, IL 604489321

    Phone: (708) 478-3000

    Fax: (708) 478-3007

    Type: Location

  • 13129, Hidden Valley Drive, Homer Glen, Will County, Illinois, 60491, United States

    HOMER GLEN, IL 604918486

    Phone: (708) 301-8723

    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: 2005-12-13

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
I20051213000162IChiropracticILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98940Chiropractic manipulative treatment, 1-2 spinal regions42738$0
98941Chiropractic manipulative treatment, 3-4 spinal regions20522$0
View full utilization report →

Insurance plans in this area (ZIP 60448)

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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: 8729050489View 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
-IL
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

Does DR. GLEN JOHN NISIVOCCIA (D C) have a public NPI I can cite?
Public records show DR. GLEN JOHN NISIVOCCIA (D C) under NPI 1689684979.
Is DR. GLEN JOHN NISIVOCCIA (D C)'s NPI status active today?
Active status means DR. GLEN JOHN NISIVOCCIA (D C)'s NPI record is not deactivated in the public file.
Which specialty label fits DR. GLEN JOHN NISIVOCCIA (D C)?
NPPES ties DR. GLEN JOHN NISIVOCCIA (D C) to Chiropractor in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. GLEN JOHN NISIVOCCIA (D C)?
DR. GLEN JOHN NISIVOCCIA (D C) is associated with Mokena, Illinois in the same public data insurers reference.
Why is information missing for DR. GLEN JOHN NISIVOCCIA (D C)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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