Active Health & Restoration, LLC

Key facts

NPI

1154792802

Entity type

Organization (NPI type 2)

Primary specialty

Rehabilitation Chiropractor 111NR0400X

License

038.012819 (IL)

Legal business name

ACTIVE HEALTH & RESTORATION, LLC

Practice address

640 E Saint Charles Rd
Suite 107
Carol Stream, IL 60188-3083

Phone

(630) 923-5049

NPI assigned

Oct 7, 2015

Organization subpart

No

Authorized official

Name

Dr. Alexander Earl, D.C. NPI 1043693575

Title

President, Clinic Director

Phone

(630) 923-5049

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

Practitioners 1

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

• Alexander E Earl, DC Rehabilitation Chiropractor · Carol Stream, IL · NPI 1043693575
  NPD (past) Authorized official REHABILITATION

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 24, 2016.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1154792802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E SAINT CHARLES RD",
            "address_2": "SUITE 107",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601883083",
            "telephone_number": "630-923-5049",
            "fax_number": "630-344-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E SAINT CHARLES RD",
            "address_2": "SUITE 107",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601883083",
            "telephone_number": "630-923-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE HEALTH & RESTORATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "EARL",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT, CLINIC DIRECTOR",
        "authorized_official_telephone_number": "630-923-5049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038.012819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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