Main Street Chiropractic and Wellness Center LTD

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

042.619502 Issued in IL

Legal business name

MAIN STREET CHIROPRACTIC AND WELLNESS CENTER LTD

Practice address

6234 S Main Street
Downers Grove, IL 60516

Phone

(630) 435-6461

NPI assigned

May 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mike Decubellis, D.C.

Title

Owner/Chiropractor

Phone

(630) 435-6461

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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

• Michael Edward Decubellis, DC

  • Chiropractor
  • Downers Grove, IL
  • NPI 1629222054
  Medicare reassignment
• Jaron Boggs

  • Chiropractor
  • Downers Grove, IL
  • NPI 1013441070
  NPD (past)
• Cara Anne Schuck, ATC

  • Athletic Trainer
  • Downers Grove, IL
  • NPI 1104170299
  NPD (past)

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1124253836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6234 S MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60516",
            "telephone_number": "630-435-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6234 S MAIN STREET",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60516",
            "telephone_number": "630-435-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHIROPRACTIC AND WELLNESS CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "DECUBELLIS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "630-435-6461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "042.619502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia Home Care Services
• Renuka Mahadevan
• Deborah Mahalski, BS
• Mahen Med Supply Corp
• Rizwan Mahmood, MD
• Main Street Square Dental, LLC
• Marek Majewski, PA-C
• Sandra Marie Makrias, M.A.
• Molly Patricia Maletich
• Rabindra Nath Malhotra, M.D.

• Medical Specialty Clinic/Center in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.