Organization Active NPI

Grateful Health and Wellness Center, PLLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1285418095
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GRATEFUL HEALTH AND WELLNESS CENTER, PLLC
Practice address
747 N. Lasalle
Suite 600E
Chicago, IL 60654-5089
Phone
(312) 692-1867
NPI assigned
Aug 22, 2023
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
GRATEFUL HEALTH AND WELLNESS CENTER, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Dr. Kenneth Owens Bennett, DCNPI 1457345522
Title
Chiropractor
Phone
(312) 692-1867

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

747 N. Lasalle
Suite 600E
Chicago, IL 60654-5089

Mailing address

6033 N Sheridan Rd Apt 18D
Chicago, IL 60660-3030
Phone (312) 692-1867

Other practice location 1

4801 W Peterson Ave Ste 305
Chicago, IL 60646-5726
Phone (312) 692-1867

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231114001411 IL Part B Supplier - Clinic/Group Practice 3173970001 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory
Part of
Grateful Health and Wellness Center PLLC

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1285418095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 N SHERIDAN RD APT 18D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603030",
            "telephone_number": "312-692-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N. LASALLE",
            "address_2": "SUITE 600E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545089",
            "telephone_number": "312-692-1867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 W Peterson Ave Ste 305",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606465726",
            "country_code": "US",
            "telephone_number": "312-692-1867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRATEFUL HEALTH AND WELLNESS CENTER, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRATEFUL HEALTH AND WELLNESS CENTER, PLLC",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "OWENS",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "312-692-1867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.