Mark M Wesely, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038009503 Issued in IL

Practice address

800 Roosevelt Rd
BLDG B Suite 112
Glen Ellyn, IL 60137-5839

Phone

(630) 790-3335

Fax

(630) 790-3345

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1457320830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROOSEVELT RD",
            "address_2": "BLDG B SUITE 112",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375839",
            "telephone_number": "630-790-3335",
            "fax_number": "630-790-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROOSEVELT RD",
            "address_2": "BLDG B SUITE 112",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375839",
            "telephone_number": "630-790-3335",
            "fax_number": "630-790-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESELY",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "02232331",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura A Weese, AU.D.
• Wellness Constellation PLLC
• Rachael A Wenzl, LMT
• Genna F Werner, LSW
• Wesely Family Chiropractic, P.C.
• Michelle L Wesely, DC
• West Suburban Laboratories
• Wheaton Counseling Associates, LTD.
• Jenna Brooke Wheeler, AUD
• Jennifer Liliani Whitesides, MSW

• Chiropractor in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Chiropractor in Illinois

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