Chicago Anti Aging Institute SC

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

Legal business name

CHICAGO ANTI AGING INSTITUTE SC

Doing business as

Chicago Anti Aging Institute

Practice address

16622 W 159TH St Ste 500
Lockport, IL 60441-8015

Phone

(815) 838-7746

Fax

(815) 838-5090

NPI assigned

Mar 22, 2019

Last updated

Mar 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Loren Davis, DCNPI 1891917795

Title

President

Phone

(708) 267-2164

Specialties & licenses 1

Addresses

Other names 1

• Chicago Anti Aging Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Loren Davis, D.C.

  • Chiropractor
  • Lockport, IL
  • NPI 1891917795
  Medicare reassignment Care Compare group NPD Authorized official
• Carleen Kaucky, C-NP

  • Nurse Practitioner
  • Hobart, IN
  • NPI 1952734295

  IL

  Medicare reassignment Care Compare group NPD
• Atul Joshi, D.O.

  • Emergency Medicine Physician
  • Harvey, IL
  • NPI 1437361722
  Medicare reassignment NPD
• Karen Ellen Wiemer X, MASSAGE THERAPIST

  • Massage Therapist
  • Lockport, IL
  • NPI 1528445715
  NPD (past)

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1003376245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16622 W 159TH ST STE 500",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418015",
            "telephone_number": "815-838-7746",
            "fax_number": "815-838-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16622 W 159TH ST STE 500",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418015",
            "telephone_number": "815-838-7746",
            "fax_number": "815-838-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO ANTI AGING INSTITUTE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LOREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-267-2164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Anti Aging Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Cella, LCSW
• Sharon Moncy Chacko
• Chatterpillar Pediatric Therapy
• Yasmin Chavez
• Denny Cheung, O.D.
• Chicago Spine Institute PC
• Jill Chokshi, APN
• Karen L. Cicirale, RN
• Tracey L. Cicirale, RD,LDN
• Jacqueline Cikowski, M.S, BCBA

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Lockport, IL
• Providers in Lockport, IL by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.