Libertyville Wellness Group, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LIBERTYVILLE WELLNESS GROUP, INC

Practice address

1785 Northwind Blvd
Libertyville, IL 60048-9617

Phone

(847) 996-0007

Fax

(847) 996-0009

NPI assigned

Oct 18, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Brian L Glaus, D.C

Title

Owner

Phone

(563) 289-3076

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Brian Robert Kelchen, D.C.

  • Chiropractor
  • Libertyville, IL
  • NPI 1730466947
  Medicare reassignment
• Bradley Hargis, DC

  • Chiropractor
  • Charlotte, NC
  • NPI 1447982798
  NPD

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1093090367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 NORTHWIND BLVD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489617",
            "telephone_number": "847-996-0007",
            "fax_number": "847-996-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 NORTHWIND BLVD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489617",
            "telephone_number": "847-996-0007",
            "fax_number": "847-996-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTYVILLE WELLNESS GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "GLAUS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-289-3076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libertyville Pediatric Dentistry
• Libertyville Podiatry
• Libertyville Podiatry PC
• Libertyville School District #70
• Libertyville Skilled Nursing Facility LLC
• Lauren Marie Libutti, RN, IBCLC
• Lifeplace, Inc.
• Tamara Lifka
• Lilly Podiatry
• Craig Lindley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.

Verify at the official NPI Registry.