NPIMap

Organization Active NPI

Koah Chiropractic LLC

Doing business as KOAH Chiropractic

  • Chiropractor
  • Romeoville, IL
National Provider Identifier
1316773666
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KOAH CHIROPRACTIC LLC
Doing business as
KOAH Chiropractic
Practice address
600 S Weber Rd Ste 9a
Romeoville, IL 60446-5065
Phone
(815) 293-3000
NPI assigned
Sep 12, 2024
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Kenneth Ross Ellul, D.C.NPI 1831733310
Title
Owner/Provider
Phone
(815) 293-3000

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 1

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

Addresses

Primary practice location

600 S Weber Rd Ste 9a
Romeoville, IL 60446-5065

Mailing address

600 S Weber Rd Ste 9
Romeoville, IL 60446-5065
Phone (815) 293-3000

Other names 1

  • KOAH Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250213001373 IL Part B Supplier - Clinic/Group Practice 8325578826 Receives reassigned benefits from 1 practitioner
Practice locations: Romeoville, IL

National Provider Directory

National Provider Directory

Locations

600 S Weber Rd
Ste 9
Romeoville, IL 60446
Phone (815) 293-3000

600 S Weber Rd
Ste 9A
Romeoville, IL 60446
Phone (815) 293-3000

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1316773666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S WEBER RD STE 9",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604465065",
            "telephone_number": "815-293-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S WEBER RD STE 9A",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604465065",
            "telephone_number": "815-293-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOAH CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "ELLUL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "815-293-3000",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KOAH Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Romeoville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.