Organization Active NPI

Innovative Health Management Inc

  • Rehabilitation Chiropractor
  • Chicago, IL
National Provider Identifier
1306199492
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
INNOVATIVE HEALTH MANAGEMENT INC
Practice address
1354 W Taylor St Ste 2
Chicago, IL 60607-4754
Phone
(312) 720-8589
NPI assigned
Oct 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Authorized official

Name
Brian Miller, DCNPI 1922177765
Title
Provider
Phone
(312) 720-8589

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X

Addresses

Primary practice location

1354 W Taylor St Ste 2
Chicago, IL 60607-4754

Mailing address

1354 W Taylor St Ste 2
Chicago, IL 60607-4754
Phone (312) 720-8589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220614001803 IL Part B Supplier - Clinic/Group Practice 1850770314 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomingdale, IL
O20220803002375 IL Part B Supplier - Clinic/Group Practice 1850770314 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomingdale, IL

National Provider Directory

National Provider Directory

Locations

215 E Lake St
Ste B
Bloomingdale, IL 60108
Phone (630) 237-4057

1354 W Taylor St
#2
Chicago, IL 60607
Phone (312) 720-8589

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1306199492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1354 W TAYLOR ST STE 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074754",
            "telephone_number": "312-720-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 W TAYLOR ST STE 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074754",
            "telephone_number": "312-720-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HEALTH MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "312-720-8589",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 May 26, 2022; 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.