Active NPI
Superior Health and Wellness of Gurnee, LTD
- Physical Medicine & Rehabilitation Physician
- Kenosha, WI
National Provider Identifier
1194497362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Legal business name
- SUPERIOR HEALTH AND WELLNESS OF GURNEE, LTD
- Practice address
- 10105 74TH St Ste 103
Kenosha, WI 53142-7530 - Phone
- (847) 858-5759
- Fax
- (847) 599-9901
- NPI assigned
- Oct 5, 2021
- Last updated
- Oct 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jodie Lynn Schultz, DC
- Title
- President
- Phone
- (847) 599-9900
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | Primary |
Addresses
Primary practice location
10105 74TH St Ste 103
Kenosha, WI 53142-7530
Mailing address
495 N Riverside Dr Ste 102
Gurnee, IL 60031-5919
Phone (847) 858-5759
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1633392000000",
"number": "1194497362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "495 N RIVERSIDE DR STE 102",
"city": "GURNEE",
"state": "IL",
"postal_code": "600315919",
"telephone_number": "847-858-5759",
"fax_number": "847-599-9901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10105 74TH ST STE 103",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531427530",
"telephone_number": "847-858-5759",
"fax_number": "847-599-9901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPERIOR HEALTH AND WELLNESS OF GURNEE, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-05",
"last_updated": "2021-10-05",
"certification_date": "2021-10-05",
"status": "A",
"authorized_official_last_name": "SCHULTZ",
"authorized_official_first_name": "JODIE",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "847-599-9900",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.