Shane Bruni

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013965 Issued in IL

Practice address

2000 Oakbrook Ctr
Oak Brook, IL 60523-9002

Phone

(630) 203-5458

NPI assigned

Feb 6, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Active Wellness, LLC

  • Chiropractor
  • Chicago, IL
  • NPI 1902162662
  Medicare reassignment NPD
• Ascend Spine & Rehab LLC

  • Chiropractor
  • St Charles, IL
  • NPI 1033096029
  NPD Authorized official
• Active Wellness LLC

  • Chiropractor
  • Chicago, IL
  • NPI 1891120408
  NPD

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1285330886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3S266 BRIARWOOD DR",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605552623",
            "telephone_number": "630-779-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OAKBROOK CTR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605239002",
            "telephone_number": "630-203-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNI",
        "first_name": "SHANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Broers, LCSW
• Brook Clinic Associates, P.C.
• Harley C Brooks III, M.D.
• Blair Meredith Brown, PSY.D.
• Latasha Brown
• Joseph C Brutzkus, MD
• Paulina N. Brzozowski-Sawicki, D.D.S.
• Stephanie Bubis Martin
• Erin O'Connell Burke, CNP
• Kaitlyn Burke, NP

• Chiropractor in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.