Lifestyle Chiropractic Wellness, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-009709 Issued in IL

Legal business name

LIFESTYLE CHIROPRACTIC WELLNESS, INC

Practice address

5290 Williams Dr
Roscoe, IL 61073-9222

Phone

(815) 623-3379

Fax

(815) 623-3380

NPI assigned

Feb 25, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Michael Donald Piller, D.C.NPI 1316044084

Title

Owner - Chiropractor

Phone

(815) 623-3379

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Donald Piller, D.C.

  • Sports Physician Chiropractor
  • Peru, IL
  • NPI 1316044084
  Medicare reassignment NPD Authorized official
• William Jeffrey Koppari, D.C.

  • Chiropractor
  • Roscoe, IL
  • NPI 1790875714
  NPD (past)

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1225378417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610730888",
            "telephone_number": "815-623-3379",
            "fax_number": "815-623-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 WILLIAMS DR",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610739222",
            "telephone_number": "815-623-3379",
            "fax_number": "815-623-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE CHIROPRACTIC WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "PILLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER - CHIROPRACTOR",
        "authorized_official_telephone_number": "815-623-3379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lazy Dog Therapeutics P.C.
• Erin Hope Lee, RDN
• Katelyn Lewis
• Life Balance Medical Center
• Lifestyle Chiropractic Group LLC
• Diana Lea Lilja, P.T.
• Paige Gail Linstead, PA-C
• Robert R Lisek, MD
• Main Square Dental
• Vicki Elizabeth Marcum, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.