Organization Active NPI

Integrated Rehabilitation Centers LTD

  • Chiropractor
  • Westmont, IL
National Provider Identifier
1003952961
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
INTEGRATED REHABILITATION CENTERS LTD
Practice address
812 E Ogden Ave
Westmont, IL 60559-1246
Phone
(630) 655-9380
Fax
(630) 655-9386
NPI assigned
Jan 29, 2007
Last updated
Mar 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Dr. Russell Elwood Manney, D.C.NPI 1316954803
Title
President
Phone
(630) 655-9380

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

812 E Ogden Ave
Westmont, IL 60559-1246

Mailing address

812 E Ogden Ave
Westmont, IL 60559-1246
Phone (630) 655-9380

Other identifiers 1

IdentifierTypeStateIssuer
02232677OtherILPROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050328000138 IL Part B Supplier - Clinic/Group Practice 0648226233 Receives reassigned benefits from 3 practitioners
Practice locations: Westmont, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1003952961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591246",
            "telephone_number": "630-655-9380",
            "fax_number": "630-655-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591246",
            "telephone_number": "630-655-9380",
            "fax_number": "630-655-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHABILITATION CENTERS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "MANNEY",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "ELWOOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-655-9380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER  NUMBER",
            "identifier": "02232677",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.