Lisle Chiropratic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013131 Issued in IL

Legal business name

LISLE CHIROPRATIC LLC

Practice address

906 Lacey Ave
Lisle, IL 60532-1318

Phone

(630) 963-1410

NPI assigned

Oct 10, 2017

Last updated

Oct 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek Justin Maitland, DCNPI 1477063147

Title

Chief Executive Officer

Phone

(630) 235-6433

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek Justin Maitland, DC

  • Chiropractor
  • Lisle, IL
  • NPI 1477063147
  Authorized official Same address or phone

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1154831600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 S ILLINOIS AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812960",
            "telephone_number": "630-235-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 LACEY AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321318",
            "telephone_number": "630-963-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISLE CHIROPRATIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "MAITLAND",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "630-235-6433",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincoln Park Hearing Center
• Bruce Linder, M.D.
• Linda A Lis, M.D.
• Lisle C U School District 202
• Lisle Chiropractic Clinic, LLC (HealthSource of Lisle)
• Lisle Dental Center P.C. (Lisle Dental Center)
• Lisle Dental Specialists,Inc
• Lisle Family Dental Inc
• Lisle-Woodridge Fire Protection District
• Jasmine Liu, DMD

• Chiropractor in Lisle, IL
• Providers in Lisle, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.