NPIMap

Organization Active NPI

Lisle Chiropractic Clinic, LLC

Doing business as HealthSource of Lisle

  • Chiropractor
  • Lisle, IL
National Provider Identifier
1033448402
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-003888 Issued in IL
Legal business name
LISLE CHIROPRACTIC CLINIC, LLC
Doing business as
HealthSource of Lisle
Practice address
1025 Ogden Ave
Lisle, IL 60532-4388
Phone
(630) 963-1410
Fax
(630) 963-1456
NPI assigned
Dec 15, 2009
Last updated
Dec 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
Mr. Raymond Ruginis, DCNPI 1265508808
Title
Owner
Phone
(630) 963-1410

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038-003888 IL Primary

Addresses

Primary practice location

1025 Ogden Ave
Lisle, IL 60532-4388

Mailing address

1025 Ogden Ave
Lisle, IL 60532-4388
Phone (630) 963-1410

Other names 1

  • HealthSource of Lisle Doing business as

National Provider Directory

National Provider Directory

Locations

1450 E Chicago Ave
Naperville, IL 60540
Phone (630) 963-1410

Practitioners & affiliated clinicians

Practitioners 2

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": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1033448402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 OGDEN AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605324388",
            "telephone_number": "630-963-1410",
            "fax_number": "630-963-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 OGDEN AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605324388",
            "telephone_number": "630-963-1410",
            "fax_number": "630-963-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISLE CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "RUGINIS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-963-1410",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-003888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Lisle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.