Chiro One Wellness Center of Peoria LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHIRO ONE WELLNESS CENTER OF PEORIA LLC

Practice address

4125 N Sheridan Rd
Peoria, IL 61614-7167

Phone

(309) 740-0977

NPI assigned

Oct 10, 2019

Organization subpart

No

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

Authorized official

Name

Sam Wang

Title

Coo

Phone

(630) 468-1824

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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

• Michael Corey Woods, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1093483380
  Medicare reassignment NPD
• Joben Thomas Barnes, DC

  • Chiropractor
  • Overland Park, KS
  • NPI 1730794777

  IL

  Medicare reassignment NPD
• Robert Allan Aarestad Jr., DC, B.S., MMP

  • Chiropractor
  • Plainfield, IL
  • NPI 1871939165
  Medicare reassignment
• Stuart Bernsen, D.C.

  • Chiropractor
  • Evanston, IL
  • NPI 1386691566
  NPD (past)

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1467094557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147167",
            "telephone_number": "309-740-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF PEORIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-468-1824"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preethi Likhitha Chintagunta, MD
• Alexander T Chiou, HIS
• Andy C. Chiou, MD
• Wun San Chiou, DDS
• Jennifer Lynn Chiras, M.S.
• Joshua Sean Chisholm, D.O.
• Subramanyam Chittivelu, M.D.
• John J Chobanian, MBC HIS
• Meghan K Chockley, PT
• Mrunal Gautam Chokshi, PT

• Chiropractor in Peoria, IL
• Providers in Peoria, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.