Organization Active NPI

M.Y Chiro & Rehab Center Inc

  • Chiropractor
  • Glenview, IL
National Provider Identifier
1376891929
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012167 Issued in IL
Legal business name
M.Y CHIRO & REHAB CENTER INC
Practice address
505 Milwaukee Ave
Glenview, IL 60025-5639
Phone
(224) 938-9468
Fax
(224) 938-9469
NPI assigned
Aug 29, 2012
Last updated
Aug 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Authorized official

Name
Min KimNPI 1699011486
Title
President
Phone
(630) 379-6237

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012167 IL Primary

Addresses

Primary practice location

505 Milwaukee Ave
Glenview, IL 60025-5639

Mailing address

505 N Milwaukee Ave
Glenview, IL 60025
Phone (224) 938-9468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130517000431 IL Part B Supplier - Clinic/Group Practice 0446497051 Receives reassigned benefits from 3 practitioners
Practice locations: Glenview, IL

National Provider Directory

National Provider Directory

Locations

505 Milwaukee Ave
Glenview, IL 60025
Phone (630) 379-6237

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1376891929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N MILWAUKEE AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60025",
            "telephone_number": "224-938-9468",
            "fax_number": "224-938-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 MILWAUKEE AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600255639",
            "telephone_number": "224-938-9468",
            "fax_number": "224-938-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M.Y CHIRO & REHAB CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-379-6237"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.