NPIMap

Organization Active NPI

Wonder Lake Chiropractic, LLC

  • Clinic/Center
  • Wonder Lake, IL
National Provider Identifier
1134541428
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
038006125 Issued in IL
Legal business name
WONDER LAKE CHIROPRACTIC, LLC
Practice address
5323 E Wonder Lake Rd
Wonder Lake, IL 60097-9051
Phone
(815) 728-0300
Fax
(815) 728-1515
NPI assigned
Jan 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Authorized official

Name
Dr. Mete A. Durum, D.C., D.A.B.C.I.
Title
Chiropractic Physician/Owner
Phone
(815) 728-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 038006125 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

Practitioners & affiliated clinicians

Practitioners 4

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": "1388966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1134541428",
    "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": "WONDER LAKE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-06",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "DURUM",
        "authorized_official_first_name": "METE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "815-728-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., D.A.B.C.I."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "038006125",
            "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 Jan 6, 2014; 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.