Concord Natural & Nutritional Healthcare, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.011509 Issued in IL

Legal business name

CONCORD NATURAL & NUTRITIONAL HEALTHCARE, PC

Practice address

800 Roosevelt Rd
B-418
Glen Ellyn, IL 60137-5839

Phone

(630) 474-9346

Fax

(630) 474-9357

NPI assigned

Feb 24, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Janice M. Hussong, DC, P.T.

Title

Owner/Ceo

Phone

(630) 935-4530

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1104148733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROOSEVELT RD",
            "address_2": "B-418",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375839",
            "telephone_number": "630-474-9346",
            "fax_number": "630-474-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROOSEVELT RD",
            "address_2": "B-418",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375839",
            "telephone_number": "630-474-9346",
            "fax_number": "630-474-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD NATURAL & NUTRITIONAL HEALTHCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "HUSSONG",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "630-935-4530",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DC, P.T."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011509",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.003626",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.