NPIMap

Organization Active NPI

Lifestyle Chiropractic & Progressive Rehab

  • Chiropractor
  • Crown Point, IN
National Provider Identifier
1083881080
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002368A Issued in IN
Legal business name
LIFESTYLE CHIROPRACTIC & PROGRESSIVE REHAB
Practice address
11065 Broadway
BLDG 12 Ste a
Crown Point, IN 46307-7301
Phone
(312) 909-1518
NPI assigned
May 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Authorized official

Name
Mitchell W Monday, DCNPI 1053588046
Title
Partner
Phone
(312) 909-1518

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 08002368A IN Primary

Addresses

Primary practice location

11065 Broadway
BLDG 12 Ste a
Crown Point, IN 46307-7301

Mailing address

13113 Delaware St
Crown Point, IN 46307-9703
Phone (312) 909-1518

National Provider Directory

National Provider Directory

Locations

11065 Broadway
Ste A
Crown Point, IN 46307
Phone (219) 663-3003

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": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1083881080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13113 DELAWARE ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079703",
            "telephone_number": "312-909-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11065 BROADWAY",
            "address_2": "BLDG 12 STE A",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077301",
            "telephone_number": "312-909-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE CHIROPRACTIC & PROGRESSIVE REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "MONDAY",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "312-909-1518",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002368A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.