Pro-Active Chiropractic & Physiotherapy

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

038011033 Issued in IL

Legal business name

PRO-ACTIVE CHIROPRACTIC & PHYSIOTHERAPY

Doing business as

TRIFACTIVE Premium Sports Injury and Pain Clinic

Practice address

3430 N Lincoln Ave
Chicago, IL 60657-1195

Phone

(773) 697-4142

NPI assigned

Jul 21, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jason Jared, D.O.

Title

Clinic Director

Phone

(773) 697-4142

Specialties & licenses 1

Addresses

Other names 1

• TRIFACTIVE Premium Sports Injury and Pain Clinic Doing business as

Locations

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1194132340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571195",
            "telephone_number": "773-697-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571195",
            "telephone_number": "773-697-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-ACTIVE CHIROPRACTIC & PHYSIOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "JARED",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "773-697-4142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038011033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRIFACTIVE Premium Sports Injury and Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rehabilitation Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Rehabilitation Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.