NPIMap

Organization Active NPI

Carl a. Nottoli, PC

  • Chiropractor
  • Libertyville, IL
National Provider Identifier
1316342124
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012174 Issued in IL
Legal business name
CARL A. NOTTOLI, PC
Practice address
900 Technology Way
210
Libertyville, IL 60048-5364
Phone
(269) 267-7937
NPI assigned
Oct 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Authorized official

Name
Dr. Carl Anthony Nottoli, DC
Title
President
Phone
(269) 267-7937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038012174 IL Primary

Addresses

Primary practice location

900 Technology Way
210
Libertyville, IL 60048-5364

Mailing address

548 Banbury Rd
Mundelein, IL 60060-1113
Phone (269) 267-7937

Other names 1

  • Functional Spine and Sport Doing business as

National Provider Directory

National Provider Directory

Locations

900 Technology Way
Ste 210
Libertyville, IL 60048
Phone (269) 267-7937

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1316342124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 BANBURY RD",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601113",
            "telephone_number": "269-267-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TECHNOLOGY WAY",
            "address_2": "210",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485364",
            "telephone_number": "269-267-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL A. NOTTOLI, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "NOTTOLI",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-267-7937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Spine and Sport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

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