Potetti'Sback in Shape Chiropactic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

POTETTI'SBACK IN SHAPE CHIROPACTIC CENTER

Practice address

5101 Washington St
Suite 2-I
Gurnee, IL 60031-5916

Phone

(847) 249-2225

Fax

(847) 249-0078

NPI assigned

Nov 29, 2007

Last updated

Nov 29, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leo Joseph Potetti Jr., D.C.NPI 1780712711

Title

President

Phone

(847) 249-2225

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Leo Joseph Potetti Jr., D.C.

  • Chiropractor
  • Gurnee, IL
  • NPI 1780712711
  NPD (past) Authorized official

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1336321587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 WASHINGTON ST",
            "address_2": "SUITE 2-I",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315916",
            "telephone_number": "847-249-2225",
            "fax_number": "847-249-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 WASHINGTON ST",
            "address_2": "SUITE 2-I",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315916",
            "telephone_number": "847-249-2225",
            "fax_number": "847-249-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTETTI'SBACK IN SHAPE CHIROPACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "POTETTI",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-249-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Podomedik Clinics LLC. (Gerardo Perez Single Member)
• Valentina Polyak, M.D.
• Pope Family Chiropractic LLC
• Sarah Poterek, DT
• Leo Joseph Potetti Jr., D.C.
• Prairie Orthodontics PC
• Prema Center, Inc.
• Eric Pressel
• Prestige Aesthetics and Hydration Lounge
• Procare Dental Group, P.C. (Grand Dentistry)

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

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