Organization Active NPI

Nova Chiropractic P.C.

  • Chiropractor
  • Wheaton, IL
National Provider Identifier
1174775167
Registry record updated Apr 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010304 Issued in IL
Legal business name
NOVA CHIROPRACTIC P.C.
Practice address
301 South County Farm Rd Unit E
Wheaton, IL 60187-0000
Phone
(630) 588-9200
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2009

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

Authorized official

Name
Dr. Jeffery Harry Carlisle, D.C.
Title
Clinic Director
Phone
(630) 588-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038010304 IL Primary

Addresses

Primary practice location

301 South County Farm Rd Unit E
Wheaton, IL 60187-0000

Mailing address

301 S County Farm Rd Ste E
Wheaton, IL 60187-4523
Phone (630) 588-9200

Other names 1

  • Nova Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

301 S County Farm Rd
Ste E
Wheaton, IL 60187
Phone (630) 588-9200

Practitioners & affiliated clinicians

Practitioners 1

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": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238716800000",
    "number": "1174775167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S COUNTY FARM RD STE E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874523",
            "telephone_number": "630-588-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SOUTH COUNTY FARM RD UNIT E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601870000",
            "telephone_number": "630-588-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2009-04-03",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "HARRY",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "630-588-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nova Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; 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.