Individual provider Active NPI

Brian Rutecki, DC

  • Chiropractor
  • Oak Brook, IL
National Provider Identifier
1104841782
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038 009500 Issued in IL
Practice address
2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234
Phone
(630) 320-6400
Fax
(630) 701-1007
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038 009500 IL Primary

Addresses

Primary practice location

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234

Mailing address

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234
Phone (630) 320-6400

Other identifiers 1

IdentifierTypeStateIssuer
022330056OtherILBCBS

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

LicenseStateTypeSpecialty
038 009500ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center Metro of Lakeview LLC Chiropractor PastSince Jul 9, 2010 Accepting new patients
Chiro One Wellness Center of Round Lake Beach LLC Chiropractor PastSince Mar 1, 2010 Accepting new patients
Chiro One Wellness Center of Libertyville LLC Chiropractor PastSince Jun 29, 2009 Accepting new patients
Chiro One Wellness Center of New Lenox LLC Chiropractor PastSince Jan 14, 2010 Accepting new patients
Chiro Wellness Center Metro of Hyde Park LLC Chiropractor PastSince Dec 8, 2010 Accepting new patients
Chiro One Wellness Center of Oswego LLC Chiropractor PastSince Oct 16, 2009 Accepting new patients
Chiro One Wellness Center of Burr Ridge LLC Chiropractor Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1104841782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-320-6400",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-320-6400",
            "fax_number": "630-701-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTECKI",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038 009500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "022330056",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.