Active NPI
Holistic Chiropractic & Rehabilitation Center, LLC
- Clinical Electrophysiology Physical Therapist
- O'Fallon, IL
National Provider Identifier
1114057312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Electrophysiology Physical Therapist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | ||
| Chiropractor | 111N00000X | IL | ||
| Chiropractor | 111N00000X | IL | ||
| Chiropractor | 111N00000X | IL | ||
| Nutrition Chiropractor | 111NN1001X | IL | ||
| Nutrition Chiropractor | 111NN1001X | IL | ||
| Nutrition Chiropractor | 111NN1001X | IL | ||
| Nutrition Chiropractor | 111NN1001X | IL | ||
| Rehabilitation Chiropractor | 111NR0400X | IL | ||
| Rehabilitation Chiropractor | 111NR0400X | IL | ||
| Rehabilitation Chiropractor | 111NR0400X | IL | ||
| Rehabilitation Chiropractor | 111NR0400X | IL | ||
| Clinical Electrophysiology Physical Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08232126 | Other | IL | IL BCBS GROUP NUMBER |
| 690962 | Other | IL | HEALTHLINK GROUP NUMBER |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Surgery Physician
- Saint Louis, MO
- NPI 1720082233
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.