Active NPI
Tanner Joseph Wilson, DC
- Nutrition Chiropractor
- Chicago, IL
National Provider Identifier
1093383994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 038013728
- Practice address
- 225 W Hubbard St Ste 302225W
Chicago, IL 60654-4916 - Phone
- (785) 448-8796
- NPI assigned
- Jun 16, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 038013728 | IL | Primary |
Addresses
Primary practice location
225 W Hubbard St Ste 302225W
Chicago, IL 60654-4916
Mailing address
225 W Hubbard St Ste 302225W
Chicago, IL 60654-4916
Phone (785) 448-8796
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038013728 | IL | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1093383994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 W HUBBARD ST STE 302225W",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606544916",
"telephone_number": "785-448-8796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 W HUBBARD ST STE 302225W",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606544916",
"telephone_number": "785-448-8796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TANNER",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-16",
"last_updated": "2021-06-16",
"certification_date": "2021-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "IL",
"license": "038013728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.