Callista C Funk, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038012202 Issued in IL

Practice address

Revive Chiropractic Healing Center
1169 W Madison St
Chicago, IL 60607

Phone

(312) 491-8100

Fax

(312) 491-8501

NPI assigned

Jul 13, 2012

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Callista C Lay LTD

  dba Genesis Chiropractic Wellness Center

  • Chiropractor
  • Chicago, IL
  • NPI 1952657991
  NPD (past)

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1295080463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 W. WASHINGTON BLVD BOX 254",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60607",
            "telephone_number": "312-491-8100",
            "fax_number": "312-491-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "REVIVE CHIROPRACTIC HEALING CENTER",
            "address_2": "1169 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60607",
            "telephone_number": "312-491-8100",
            "fax_number": "312-491-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "CALLISTA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Fung
• Michael Fung, PHD
• PO Ling Fung, APN
• Sharon Chyihuey Fung, MS, APN-CNS, CRRN
• Arthur Dominic Funk, M.D.
• Colin Thomas Funk
• Hailey Funk, MS, CGC
• Katrina Ann Funk, MAAT, LPC
• Megan Funk, LPC
• Stevie Nicole Funk, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.