Spine Institute of Waukegan

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

Legal business name

SPINE INSTITUTE OF WAUKEGAN

Practice address

2634 Grand Ave Suite 100
Waukegan, IL 60085-2458

Phone

(847) 775-0800

Fax

(847) 775-0888

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Kelly G Worth, DC

Title

Clinic Director

Phone

(847) 775-0800

Specialties & licenses 1

Addresses

Practitioners 2

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

• Aaron Schreiber, DC

  • Chiropractor
  • Evanston, IL
  • NPI 1467710731
  NPD (past)
• Ronald T Samaniego, PHYSICAL THERAPIST

  • Physical Therapist
  • Spring Hill, FL
  • NPI 1447451380
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366654501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 GRAND AVE SUITE 100",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852458",
            "telephone_number": "847-775-0800",
            "fax_number": "847-775-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 GRAND AVE SUITE 100",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852458",
            "telephone_number": "847-775-0800",
            "fax_number": "847-775-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE INSTITUTE OF WAUKEGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WORTH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "847-775-0800",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis Sommer, CNM
• Miki K Son
• Samantha Sotelo
• Spine & Joint Institute of Lake County
• Spine & Nerve Testing Center
• James Spiziri
• Kelly Spratt-Szarzynski
• Karen Srill-Jaffe
• Teresa Michelle St. Luce
• Lisa G Stadler, RN,BSN

• Neurology Chiropractor in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Neurology Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.