Active NPI
Evolve Chiropractic Woodstock PLLC
- Chiropractor
- Woodstock, IL
National Provider Identifier
1063908218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038-012415
- Legal business name
- EVOLVE CHIROPRACTIC WOODSTOCK PLLC
- Practice address
- 2440 Lake Shore Drive
Woodstock, IL 60098-2980 - Phone
- (815) 338-9150
- NPI assigned
- Jul 10, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ryan Felde
- Title
- Billing Manager
- Phone
- (847) 345-7676
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-012415 | IL | Primary |
Addresses
Primary practice location
2440 Lake Shore Drive
Woodstock, IL 60098-2980
Mailing address
10705 Ruth Rd
Huntley, IL 60142-7156
Phone (815) 338-9150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730526104 | Other | INDIVIDUAL NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2440 Lake Shore Dr
Woodstock, IL 60098
Phone (815) 338-9150
Practitioners & affiliated clinicians
Practitioners 10
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531180800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716940800000",
"number": "1063908218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10705 RUTH RD",
"city": "HUNTLEY",
"state": "IL",
"postal_code": "601427156",
"telephone_number": "815-338-9150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 LAKE SHORE DRIVE",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600982980",
"telephone_number": "815-338-9150"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVOLVE CHIROPRACTIC WOODSTOCK PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-07-10",
"last_updated": "2024-05-29",
"certification_date": "2024-05-29",
"status": "A",
"authorized_official_last_name": "FELDE",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "847-345-7676",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "IL",
"license": "038-012415",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL NPI",
"identifier": "1730526104",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Woodstock, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.