Organization Active NPI

Spinal Health Clinic Inc

  • Chiropractor
  • Wood Dale, IL
National Provider Identifier
1114116795
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SPINAL HEALTH CLINIC INC
Practice address
345 E Irving Park Rd
Wood Dale, IL 60191-1621
Phone
(630) 766-6200
Fax
(630) 496-0315
NPI assigned
Oct 18, 2007
Last updated
Apr 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Dr. Nancy J Cannon, D.C.NPI 1184798530
Title
Chiropractor
Phone
(630) 766-6200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

345 E Irving Park Rd
Wood Dale, IL 60191-1621

Mailing address

345 E Irving Park Rd
Wood Dale, IL 60191-1621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080408000132 IL Part B Supplier - Clinic/Group Practice 8325125966 Receives reassigned benefits from 1 practitioner
Practice locations: Wood Dale, IL

National Provider Directory

National Provider Directory

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": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1114116795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911621",
            "fax_number": "630-496-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911621",
            "telephone_number": "630-766-6200",
            "fax_number": "630-496-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "630-766-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood Dale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.