Premier Chiropractic Center, LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PREMIER CHIROPRACTIC CENTER, LTD

Practice address

419 Center St
Suite B
Grayslake, IL 60030-1625

Phone

(847) 543-1055

NPI assigned

Aug 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Nolan BoumaNPI 1649455502

Title

Physician

Phone

(847) 543-1055

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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

• John Nolan Bouma, DC

  • Chiropractor
  • Grayslake, IL
  • NPI 1649455502
  Medicare reassignment Authorized official
• Krystine Bird

  • Massage Therapist
  • Grayslake, IL
  • NPI 1417357674
  NPD (past)
• Lindsay Daun

  • Massage Therapist
  • Grayslake, IL
  • NPI 1760882922
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1336156280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 CENTER ST",
            "address_2": "SUITE B",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301625",
            "telephone_number": "847-543-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 CENTER ST",
            "address_2": "SUITE B",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301625",
            "telephone_number": "847-543-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHIROPRACTIC CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "BOUMA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NOLAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-543-1055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID #",
            "identifier": "4926003",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn C Podlasek, D.D.S.
• Biana M Polak, DO
• Arthur Popov
• Sheila Posedel, PT
• Powers Wellness & Consulting Group, LLC (Victoria Priola)
• Premise Health of Illinois Medical PC (MCL Health Center)
• Kellen Price, NCC, LPC
• Prime Homecare Inc (Home Instead Senior Care 108)
• Psych Vip LLC
• Psychwise Services LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.