NPIMap

Organization Active NPI

Dennis R Zidek DC

  • Chiropractor
  • Wonder Lake, IL
National Provider Identifier
1114363322
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-003651 Issued in IL
Legal business name
DENNIS R ZIDEK DC
Practice address
5323 E Wonder Lake Rd
Wonder Lake, IL 60097-9051
Phone
(815) 728-0300
Fax
(815) 728-1515
NPI assigned
May 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Authorized official

Name
Dr. Dennis R Zidek, D.C.
Title
Owner
Phone
(815) 728-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038-003651 IL Primary

Addresses

Primary practice location

5323 E Wonder Lake Rd
Wonder Lake, IL 60097-9051

Mailing address

5323 E Wonder Lake Rd
Wonder Lake, IL 60097-9051
Phone (815) 728-0300

National Provider Directory

National Provider Directory

Locations

5323 E Wonder Lake Rd
Wonder Lake, IL 60097
Phone (815) 653-0077

Practitioners & affiliated clinicians

Practitioners 5

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": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1114363322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 E WONDER LAKE RD",
            "city": "WONDER LAKE",
            "state": "IL",
            "postal_code": "600979051",
            "telephone_number": "815-728-0300",
            "fax_number": "815-728-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 E WONDER LAKE RD",
            "city": "WONDER LAKE",
            "state": "IL",
            "postal_code": "600979051",
            "telephone_number": "815-728-0300",
            "fax_number": "815-728-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS R ZIDEK DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "ZIDEK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-728-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-003651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wonder Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.