Organization Active NPI

Optimal Health & Wellness P.C.

  • Chiropractor
  • Shorewood, IL
National Provider Identifier
1114074531
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010057 Issued in IL
Legal business name
OPTIMAL HEALTH & WELLNESS P.C.
Practice address
568 Brook Forest Ave.
Shorewood, IL 60404-9706
Phone
(815) 725-5733
Fax
(815) 725-5722
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Authorized official

Name
Dr. Ryan M. Wuebben, D.C.
Title
President
Phone
(815) 725-5733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038-010057 IL Primary

Addresses

Primary practice location

568 Brook Forest Ave.
Shorewood, IL 60404-9706

Mailing address

25240 Balmoral Dr
Shorewood, IL 60431-8371
Phone (563) 340-3337

National Provider Directory

National Provider Directory

Locations

568 Brook Forest Ave
Shorewood, IL 60404
Phone (815) 725-5733

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1114074531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25240 BALMORAL DR",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604318371",
            "telephone_number": "563-340-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 BROOK FOREST AVE.",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604049706",
            "telephone_number": "815-725-5733",
            "fax_number": "815-725-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH & WELLNESS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "WUEBBEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-725-5733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.