Lisle Chiropractic Clinic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-003888 Issued in IL

Legal business name

LISLE CHIROPRACTIC CLINIC, LLC

Practice address

1025 Ogden Ave
Lisle, IL 60532-4388

Phone

(630) 963-1410

Fax

(630) 963-1456

NPI assigned

Dec 15, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Raymond Ruginis, DC

Title

Owner

Phone

(630) 963-1410

Specialties & licenses 1

Addresses

Other names 1

• HealthSource of Lisle Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Justin Maitland, DC

  • Chiropractor
  • Lisle, IL
  • NPI 1477063147
  NPD (past)

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"
        }
    ]
}

• Rosaleen Uyecio Lim, APN
• Lincoln Park Hearing Center
• Bruce Linder, M.D.
• Linda A Lis, M.D.
• Lisle C U School District 202
• Lisle Chiropratic LLC
• Lisle Dental Center P.C.
• Lisle Dental Specialists,Inc
• Lisle Family Dental Inc
• Lisle-Woodridge Fire Protection District

• Chiropractor in Lisle, IL
• Providers in Lisle, IL by specialty
• Chiropractor in Illinois

• 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.