Organization Active NPI

Center for Progressive Natural Health LLC

  • Chiropractor
  • Crystal Lake, IL
National Provider Identifier
1396889952
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CENTER FOR PROGRESSIVE NATURAL HEALTH LLC
Practice address
318 Memorial Dr
Suite 200
Crystal Lake, IL 60014-6267
Phone
(815) 455-1910
Fax
(815) 455-2541
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Authorized official

Name
Mr. James E McGinn Jr., D.C.NPI 1851346498
Title
Owner
Phone
(815) 455-1910

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X IL Primary

Addresses

Primary practice location

318 Memorial Dr
Suite 200
Crystal Lake, IL 60014-6267

Mailing address

318 Memorial Dr
Suite 200
Crystal Lake, IL 60014-6267
Phone (815) 455-1910

Other identifiers 1

IdentifierTypeStateIssuer
04923223OtherILBLUE CROSS BLUE SHIELD IL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001278 IL Part B Supplier - Clinic/Group Practice 5597751404 Receives reassigned benefits from 1 practitioner
Practice locations: Crystal Lake, IL

National Provider Directory

National Provider Directory

Locations

318 Memorial Dr
Ste 200
Crystal Lake, IL 60014
Phone (815) 455-1910

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1396889952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 MEMORIAL DR",
            "address_2": "SUITE 200",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146267",
            "telephone_number": "815-455-1910",
            "fax_number": "815-455-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MEMORIAL DR",
            "address_2": "SUITE 200",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146267",
            "telephone_number": "815-455-1910",
            "fax_number": "815-455-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PROGRESSIVE NATURAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "MCGINN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-455-1910",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "04923223",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.