NPIMap

Organization Active NPI

Addison Physical Medicine and Rehabilitation Center LTD.

  • Chiropractor
  • Wood Dale, IL
National Provider Identifier
1407853393
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ADDISON PHYSICAL MEDICINE AND REHABILITATION CENTER LTD.
Practice address
199 S. Addison Rd.
Suite #106
Wood Dale, IL 60191-1534
Phone
(630) 766-1552
Fax
(630) 766-4220
NPI assigned
Jul 7, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Edward Michael Krys, D.C.NPI 1568492296
Title
Owner
Phone
(630) 766-1552

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary
Chiropractor 111N00000X 038008124 IL
Physical Therapist 225100000X IL

Addresses

Primary practice location

199 S. Addison Rd.
Suite #106
Wood Dale, IL 60191-1534

Mailing address

199 S. Addison Rd.
Suite #106
Wood Dale, IL 60191-1534
Phone (630) 766-1552

Other identifiers 2

IdentifierTypeStateIssuer
02222753OtherILBCBSIL
02222753OtherILBC

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407853393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 S. ADDISON RD.",
            "address_2": "SUITE #106",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911534",
            "telephone_number": "630-766-1552",
            "fax_number": "630-766-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 S. ADDISON RD.",
            "address_2": "SUITE #106",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911534",
            "telephone_number": "630-766-1552",
            "fax_number": "630-766-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDISON PHYSICAL MEDICINE AND REHABILITATION CENTER LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KRYS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-766-1552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008124",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "02222753",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "02222753",
            "state": "IL"
        }
    ],
    "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 Jul 21, 2022; 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.