NPIMap

Organization Active NPI

JLV1 LLC

Doing business as Advance Spine & Rehab Center

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1356786867
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011879 Issued in IL
Legal business name
JLV1 LLC
Doing business as
Advance Spine & Rehab Center
Practice address
3139 W 111TH St
Chicago, IL 60655-2205
Phone
(773) 767-3822
Fax
(773) 337-9106
NPI assigned
May 10, 2013
Last updated
May 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Authorized official

Name
Lynnette McRoy
Title
Billing Coordinator
Phone
(773) 767-3822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011879 IL Primary

Addresses

Primary practice location

3139 W 111TH St
Chicago, IL 60655-2205

Mailing address

3139 W 111TH St
Chicago, IL 60655-2205
Phone (773) 767-3822

Other names 1

  • Advance Spine & Rehab Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1356786867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3139 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552205",
            "telephone_number": "773-767-3822",
            "fax_number": "773-337-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3139 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552205",
            "telephone_number": "773-767-3822",
            "fax_number": "773-337-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLV1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "MCROY",
        "authorized_official_first_name": "LYNNETTE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "773-767-3822"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Spine & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.