Hyde Park Chiropractic Wellness Center SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038007681 Issued in IL

Legal business name

HYDE PARK CHIROPRACTIC WELLNESS CENTER SC

Practice address

1304 E 47TH St Ste 201
Chicago, IL 60653-4695

Phone

(773) 493-7034

Fax

(773) 493-5521

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Rolande D Balan, DCNPI 1750378006

Title

Owner

Phone

(773) 493-7034

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Rolande D Balan, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1750378006
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1104926344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 E 47TH ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534695",
            "telephone_number": "773-493-7034",
            "fax_number": "773-493-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 E 47TH ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534695",
            "telephone_number": "773-493-7034",
            "fax_number": "773-493-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK CHIROPRACTIC WELLNESS CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "BALAN",
        "authorized_official_first_name": "ROLANDE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-493-7034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Hyche
• Nosheen H Hydari, MS MFT, LMFT
• Hyde Park Amazing Dental LLC
• Hyde Park Associates in Medicine LTD
• Hyde Park Center for Healing LLC
• Hyde Park Counseling & Therapy PLLC
• Hyde Park Counseling & Therapy PLLC
• Hyde Park Dental Profile
• Hyde Park Foot Care PLLC
• Hyde Park Medical Specialty Group, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.