Advance Performance Pain and Wellness Center

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

038010696 Issued in IL

Legal business name

ADVANCE PERFORMANCE PAIN AND WELLNESS CENTER

Practice address

1222 N Eola Rd
Aurora, IL 60502-9409

Phone

(630) 499-8804

Fax

(630) 820-1360

NPI assigned

Jan 12, 2017

Last updated

Jan 12, 2017By 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

Jason Fennema, D.C.NPI 1386657690

Title

President

Phone

(630) 456-5315

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

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.

• Jason G Fennema, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1386657690
  Medicare reassignment Care Compare group NPD Authorized official
• Binky Bawa, PT

  • Physical Therapist
  • Lake in the Hills, IL
  • NPI 1770972473
  Medicare reassignment Care Compare group NPD
• Uri Ondras

  • Physical Therapist
  • New Lenox, IL
  • NPI 1346825064
  Medicare reassignment Care Compare group NPD
• Tamara Lifka

  • Physical Therapist
  • Libertyville, IL
  • NPI 1962190553
  Medicare reassignment NPD

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1356887475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 N EOLA RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029409",
            "telephone_number": "630-499-8804",
            "fax_number": "630-820-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 N EOLA RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605029409",
            "telephone_number": "630-499-8804",
            "fax_number": "630-820-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE PERFORMANCE PAIN AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "FENNEMA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-456-5315",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038010696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Adeli
• Payam Victor Aderangi
• Ruaa Adham
• Lauren Lynn Adolfino, QMHP
• Aida Adriano
• Advanced Family Dental of Naperville, P.C.
• Advanced Practice Associates (Advanced Practice Assocates)
• Advanced Primary Health Care SC
• Adventist Health Partners, Inc (UChicago Medicine AdventHealth Centra Care)
• Advocate Health and Hospitals Corporation (Advocate Medical Group (Dreyer))

• Rehabilitation Chiropractor in Aurora, IL
• Providers in Aurora, IL by specialty
• Rehabilitation Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.