Integrative Wellness Clinic LTD.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

038.009006 Issued in IL

Legal business name

INTEGRATIVE WELLNESS CLINIC LTD.

Practice address

9631 Gross Point Rd
Ste.107
Skokie, IL 60076-1264

Phone

(224) 534-7167

NPI assigned

Dec 27, 2010

Last updated

Jan 3, 2014By 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

Dr. Tatiyana M Urbin, D.C.NPI 1184665028

Title

Owner

Phone

(224) 534-7167

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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.

• Tatiyana M Urbin, DC

  • Chiropractor
  • Skokie, IL
  • NPI 1184665028
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1225332703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 GROSS POINT RD",
            "address_2": "STE.203",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761173",
            "telephone_number": "224-534-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 GROSS POINT RD",
            "address_2": "STE.107",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761264",
            "telephone_number": "224-534-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE WELLNESS CLINIC LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "URBIN",
        "authorized_official_first_name": "TATIYANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-534-7167",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "038.009006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Skokie, IL
• Providers in Skokie, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.