NPIMap

Organization Active NPI

Bioblu, LLC

  • Chiropractor
  • Hickory Hills, IL
National Provider Identifier
1346495512
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011278 Issued in IL
Legal business name
BIOBLU, LLC
Practice address
9229 S 78TH Ave
Hickory Hills, IL 60457-2133
Phone
(866) 288-3822
NPI assigned
Dec 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Dr. Ryan Daniel Novak, D.C.NPI 1003052838
Title
Advisory Physician
Phone
(866) 288-3822

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038011278 IL Primary
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X 038011278 IL
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X 038011143 IL
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X 038011278 IL
Thermography ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NT0100X 038011278 IL
Thermography ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NT0100X 038011143 IL

Addresses

Primary practice location

9229 S 78TH Ave
Hickory Hills, IL 60457-2133

Mailing address

9229 S 78TH Ave
Hickory Hills, IL 60457-2133
Phone (866) 288-3822

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1346495512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9229 S 78TH AVE",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604572133",
            "telephone_number": "866-288-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9229 S 78TH AVE",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604572133",
            "telephone_number": "866-288-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOBLU, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "ADVISORY PHYSICIAN",
        "authorized_official_telephone_number": "866-288-3822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011278",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038011278",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038011143",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": "038011278",
            "primary": false
        },
        {
            "code": "111NT0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Thermography",
            "state": "IL",
            "license": "038011278",
            "primary": false
        },
        {
            "code": "111NT0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Thermography",
            "state": "IL",
            "license": "038011143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.