Individual provider Active NPI

Tyler Zoesch, DC

  • Chiropractor
  • Libertyville, IL
National Provider Identifier
1053734053
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012579 Issued in IL
Practice address
149 Buckley Rd
Libertyville, IL 60048-1400
Phone
(224) 207-4180
NPI assigned
Jan 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012579 IL Primary

Addresses

Primary practice location

149 Buckley Rd
Libertyville, IL 60048-1400

Mailing address

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322000949 IL Practitioner - Chiropractic 4587961362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

149 Buckley Rd
Libertyville, IL 60048-1400
Phone (224) 207-4180

1916 Il Route 83
Round Lake Beach, IL 60073-2200
Phone (847) 543-6957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012579ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center of Round Lake Beach LLC Chiropractor CurrentSince Sep 20, 2023 Accepting new patients
Chiro One Wellness Center of Libertyville LLC Chiropractor CurrentSince Mar 21, 2016 Accepting new patients

Locations

149 Buckley Rd
Libertyville, IL 60048
Phone (224) 207-4180

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523
Phone (800) 613-0922

1916 Il Route 83
Round Lake Beach, IL 60073
Phone (847) 543-6957

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1053734053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 BUCKLEY RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481400",
            "telephone_number": "224-207-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOESCH",
        "first_name": "TYLER",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.