Organization Active NPI

Full Strength Spine and Health Center LLC

  • Chiropractor
  • Orland Park, IL
National Provider Identifier
1255723615
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012769 Issued in IL
Legal business name
FULL STRENGTH SPINE AND HEALTH CENTER LLC
Practice address
10761 163Rd PL
Orland Park, IL 60467-8861
Phone
(708) 403-9450
NPI assigned
Feb 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Timothy GilbertNPI 1437549136
Title
Chiropractic Physician / Owner
Phone
(708) 403-9450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038.012769 IL Primary

Addresses

Primary practice location

10761 163Rd PL
Orland Park, IL 60467-8861

Mailing address

10761 163Rd PL
Orland Park, IL 60467-8861
Phone (708) 403-9450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150429001337 IL Part B Supplier - Clinic/Group Practice 0042539868 Receives reassigned benefits from 1 practitioner
Practice locations: Orland Park, IL

National Provider Directory

National Provider Directory

Locations

9601 165th St
Ste 4
Orland Park, IL 60467
Phone (708) 403-9450

10761 163rd Pl
Orland Park, IL 60467
Phone (708) 403-9450

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1255723615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10761 163RD PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678861",
            "telephone_number": "708-403-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10761 163RD PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678861",
            "telephone_number": "708-403-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL STRENGTH SPINE AND HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "708-403-9450"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.