Bria Clinic Pain & Injury Relief Center SC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

038-008995 Issued in IL

Legal business name

BRIA CLINIC PAIN & INJURY RELIEF CENTER SC

Practice address

161 Market St
Willow Springs, IL 60480-1613

Phone

(630) 649-2658

NPI assigned

Oct 19, 2010

Last updated

Nov 3, 2010By 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

John SpallaNPI 1780690719

Title

Business Owner

Phone

(630) 649-2658

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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.

• John Thomas Spalla, DC

  • Internist Chiropractor
  • Burbank, IL
  • NPI 1780690719
  Medicare reassignment NPD Authorized official
• Bradley John Martin, D.C.

  • Chiropractor
  • Willow Springs, IL
  • NPI 1609955459
  NPD (past)
• Kenneth Michael Martin, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1689872509
  NPD (past)

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1255641635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MARKET ST",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801613",
            "telephone_number": "630-649-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MARKET ST",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801613",
            "telephone_number": "630-649-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIA CLINIC PAIN & INJURY RELIEF CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "SPALLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "630-649-2658"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038-008995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald J Barry, L.C.S.W.
• Kayle Marie Benoit, LCSW
• Melissa Betance, ND, CNS, LDN
• Emerson Black, MA, LPC, NCC
• James Borre, PTA
• Kimberly Hope Brock, LMSW
• Zachary Chase, DC
• Soohyun Jessica Chon, PHARM.D
• Angelica Creech, LCSW
• Dr. John Awah & Associates, LTD.

• Rehabilitation Chiropractor in Willow Springs, IL
• Providers in Willow Springs, IL by specialty
• Rehabilitation Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.