Back to Basics Chiropractic Health Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BACK TO BASICS CHIROPRACTIC HEALTH CENTER, LLC

Practice address

1318 Chicago Ave
Evanston, IL 60201-4725

Phone

(847) 475-4960

Fax

(847) 475-4966

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Heather Noelle Mantey-Vanloocke, D.C.

Title

Owner/Manager

Phone

(847) 475-4960

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1306030754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014725",
            "telephone_number": "847-475-4960",
            "fax_number": "847-475-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014725",
            "telephone_number": "847-475-4960",
            "fax_number": "847-475-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO BASICS CHIROPRACTIC HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "MANTEY-VANLOOCKE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "NOELLE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "847-475-4960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefani Azores-Gococo, LPC
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• Steven J Bachta, M.D.
• Back-N-Balance Physical Therapy and Rehab Specialists
• Maria Iana Baczek, MSN, RN
• John Badagliacco, MS
• Ami Umesh Badami, M.D.
• Diana Baden, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.