NPIMap

Organization Active NPI

Progressive Chiropractic Wellness & Rehab Centre, P.C.

  • Point of Service
  • Loves Park, IL
National Provider Identifier
1023206265
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
038009877 Issued in IL
Legal business name
PROGRESSIVE CHIROPRACTIC WELLNESS & REHAB CENTRE, P.C.
Practice address
6270 E Riverside Blvd
Loves Park, IL 61111-4418
Phone
(815) 636-2225
NPI assigned
Oct 12, 2007
Last updated
Oct 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Dr. Aaron Woodyatt, DCNPI 1871637645
Title
Owner
Phone
(815) 636-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 038009629 IL
Point of Service 305S00000X 038009877 IL Primary

Addresses

Primary practice location

6270 E Riverside Blvd
Loves Park, IL 61111-4418

Mailing address

6270 E Riverside Blvd
Loves Park, IL 61111-4418

National Provider Directory

National Provider Directory

Locations

6270 E Riverside Blvd
Loves Park, IL 61111
Phone (815) 636-2225

3957 N Mulford Rd
Ste B
Rockford, IL 61114
Phone (815) 636-2225

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1023206265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6270 E RIVERSIDE BLVD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6270 E RIVERSIDE BLVD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114418",
            "telephone_number": "815-636-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE CHIROPRACTIC WELLNESS & REHAB CENTRE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "WOODYATT",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-636-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "IL",
            "license": "038009629",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "IL",
            "license": "038009877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.