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Deactivated NPI 1558464834 Deactivated / Inactive NPI Male Practitioner

Dr. Gary Roe Street , DC, PHC, LCP

Chiropractor • Olney, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gary Street has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 05, 2006
NPI Deactivation Date August 12, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Gary Street, DC, PHC, LCP was a registered Chiropractor practicing in Olney, IL. Throughout an active medical career spanning 15 years, Dr. Street provided care at the practice location at 400 S WEST ST until profile deactivation on 2021-08-12.

Historical Medicare Part B clinical services included chiropractic manipulative treatment, 3-4 spinal regions. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

400 S West St

Olney, IL 624501217

Telephone 6183953162
Fax 6183958111
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Olney, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 29.3 Yrs
State Avg: 23.6 Yrs
Regional Practice Density
7 Specialists

Practicing in Olney, IL (4730 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
2.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
98941 Chiropractic manipulative treatment, 3-4 spinal regions
51 41 $38.00 $37.23

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License IL 038-003230

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 12, 2021

Record deactivated on August 12, 2021

NPI Profile Active September 05, 2012

NPI status registered as active in NPPES database

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Updated Practice Location September 05, 2012

Registered at 400 S WEST ST, OLNEY, IL 624501217 (Tel: 6183953162)

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Updated Business Mailing Address September 05, 2012

Registered at 400 SOUTH WEST STREET, OLNEY, IL 624501217 (Tel: 6183953162)

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Provider Name / Credentials Updated September 05, 2012

Recorded as GARY STREET, D.C., PH.C., L.C.P.,

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 05, 2012

Chiropractor (License #038-003230 in IL)

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Initial NPI Registration & Enumeration September 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1558464834
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 05, 2006
Last Update: September 05, 2012
Deactivation Date: August 12, 2021

Mailing Address

400 South West Street

Olney, IL 624501217

Phone: 6183953162

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.