Organization Active NPI

Holistic Chiropractic & Rehabilitation Center, LLC

  • Clinical Electrophysiology Physical Therapist
  • O'Fallon, IL
National Provider Identifier
1114057312
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X
Legal business name
HOLISTIC CHIROPRACTIC & REHABILITATION CENTER, LLC
Practice address
4965 Stone Falls Ctr
Suite 7
O Fallon, IL 62269-7802
Phone
(618) 624-9384
Fax
(618) 624-9386
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Joseph F. Lahue
Title
Administrator
Phone
(618) 624-9384

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X IL
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X IL
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X IL
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X IL
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X IL
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X IL
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X IL
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X IL
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X IL
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X IL
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X IL
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X IL
Clinical Electrophysiology Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251E1300X IL Primary

Addresses

Primary practice location

4965 Stone Falls Ctr
Suite 7
O Fallon, IL 62269-7802

Mailing address

4965 Stone Falls Ctr
Suite 7
O Fallon, IL 62269-7802
Phone (618) 624-9384

Other identifiers 2

IdentifierTypeStateIssuer
08232126OtherILIL BCBS GROUP NUMBER
690962OtherILHEALTHLINK GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

4965 Stone Falls Ctr
Ste 7
O Fallon, IL 62269
Phone (618) 622-9780

4965 Stone Falls Ctr
Ste 2
O Fallon, IL 62269
Phone (314) 644-1411

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1114057312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 STONE FALLS CTR",
            "address_2": "SUITE 7",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697802",
            "telephone_number": "618-624-9384",
            "fax_number": "618-624-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 STONE FALLS CTR",
            "address_2": "SUITE 7",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697802",
            "telephone_number": "618-624-9384",
            "fax_number": "618-624-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC CHIROPRACTIC & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LAHUE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-624-9384",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BCBS GROUP NUMBER",
            "identifier": "08232126",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK GROUP NUMBER",
            "identifier": "690962",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.