Chiro One Wellness Center of Crystal Lake SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHIRO ONE WELLNESS CENTER OF CRYSTAL LAKE SC

Practice address

435 Angela LN Ste 12
Crystal Lake, IL 60014-1074

Phone

(815) 301-4200

Fax

(815) 301-4205

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sam Wang, DCNPI 1073520136

Title

Coo

Phone

(630) 468-1824

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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

• Michael T Socha, D.C.

  • Chiropractor
  • Crystal Lake, IL
  • NPI 1326473398
  Medicare reassignment NPD
• Sam Wang, DC

  • Chiropractor
  • Libertyville, IL
  • NPI 1073520136
  NPD (past) Authorized official
• Clinton J Garda, DC

  • Chiropractor
  • Cincinnati, OH
  • NPI 1417084286
  NPD (past)
• April M Waltke, P.A.-C.

  • Physician Assistant
  • Fort Wayne, IN
  • NPI 1508833674
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1124155098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-468-1824",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 ANGELA LN STE 12",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141074",
            "telephone_number": "815-301-4200",
            "fax_number": "815-301-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF CRYSTAL LAKE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-468-1824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5632232",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryliene a Niemo PLLC
• Rebecca E Cheski, ATC
• Children'S Physician Group
• Jamie So-Yung Chin, M.D.
• Donald Bruce Chinlund, D.D.S., LLC
• Gina C Chmela, APN
• Autumn Chmielewski, MAT, MS, BCBA
• Danny Cho, DO
• Lindsey Rose Choklad, MSW, CADC
• Pinal Chokshi, DO

• Chiropractor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.