Individual provider Active NPI

Michael Nathan Drzewiecki, DC

  • Neurology Chiropractor
  • Wood Dale, IL
National Provider Identifier
1386040681
Registry record updated Dec 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
038.012992 Issued in IL
Practice address
199 S Addison Rd
#106
Wood Dale, IL 60191-1929
Phone
(810) 252-1804
NPI assigned
Nov 13, 2014
Last updated
Dec 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 038.012992 IL Primary
Sports Physician Chiropractor 111NS0005X 038.012992 IL

Addresses

Primary practice location

199 S Addison Rd
#106
Wood Dale, IL 60191-1929

Mailing address

199 S Addison Rd
#106
Wood Dale, IL 60191-1929
Phone (810) 252-1804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210324002847 IL Practitioner - Chiropractic 0244647931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012992ILMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Neuro & Physical Rehabilitation LTD CurrentSince Mar 18, 2021 Accepting new patients
Neurologic Wellness Institute PLLC Neurology Current Accepting new patients
The Neurologic Wellness Institute, LLC Neurology Current Accepting new patients

Locations

199 S Addison Rd
Wood Dale, IL 60191
Phone (630) 766-1552

199 S Addison Rd
#105106
Wood Dale, IL 60191
Phone (630) 766-1552

199 S Addison Rd
Ste 106
Wood Dale, IL 60191
Phone (630) 766-1552

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483142400000",
    "number": "1386040681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 S ADDISON RD",
            "address_2": "#106",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911929",
            "telephone_number": "810-252-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 S ADDISON RD",
            "address_2": "#106",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911929",
            "telephone_number": "810-252-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRZEWIECKI",
        "first_name": "MICHAEL",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-13",
        "last_updated": "2016-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038.012992",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038.012992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood Dale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2016; 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.