Organization Active NPI

Rehab Lab LLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1053907196
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
REHAB LAB LLC
Practice address
2577 W Armitage Ave
Chicago, IL 60647-4324
Phone
(224) 456-7165
NPI assigned
Dec 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Authorized official

Name
Dr. Michael Risher, DCNPI 1982242186
Title
Owner
Phone
(224) 456-7165

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: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2577 W Armitage Ave
Chicago, IL 60647-4324

Mailing address

2236 W Cornelia Ave # 2
Chicago, IL 60618-6035
Phone (224) 456-7165

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL rehablab.janeapp.com Direct

National Provider Directory

National Provider Directory

Locations

2577 W Armitage Ave
Chicago, IL 60647
Phone (224) 456-7165

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1053907196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2236 W CORNELIA AVE # 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186035",
            "telephone_number": "224-456-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 W ARMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474324",
            "telephone_number": "224-456-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "RISHER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-456-7165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rehablab.janeapp.com",
            "affiliation": "N",
            "endpointDescription": "Online Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2577 W Armitage Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606474324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.