NPIMap

Organization Active NPI

Round Lake Beach Chiropractic, S.C.

  • Chiropractor
  • Lake Villa, IL
National Provider Identifier
1295859569
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038006409 Issued in IL
Legal business name
ROUND LAKE BEACH CHIROPRACTIC, S.C.
Practice address
36735 N Il Route 83
Lake Villa, IL 60046-9619
Phone
(847) 265-5600
Fax
(847) 245-4491
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Authorized official

Name
Holly Lynne Allen
Title
Administrator
Phone
(847) 265-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038006409 IL Primary

Addresses

Primary practice location

36735 N Il Route 83
Lake Villa, IL 60046-9619

Mailing address

36735 N Il Route 83
Lake Villa, IL 60046-9619
Phone (847) 265-5600

National Provider Directory

National Provider Directory

Locations

36735 N Il Route 83
Lake Villa, IL 60046
Phone (847) 265-5600

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1295859569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36735 N IL ROUTE 83",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469619",
            "telephone_number": "847-265-5600",
            "fax_number": "847-245-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36735 N IL ROUTE 83",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469619",
            "telephone_number": "847-265-5600",
            "fax_number": "847-245-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND LAKE BEACH CHIROPRACTIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-265-5600"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Villa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.