Back Center of Chicago

Primary specialty

SpecialistTaxonomy code 174400000X

License

36-037992 Issued in IL

Legal business name

BACK CENTER OF CHICAGO

Practice address

1731 N Marcey St
Suite 530
Chicago, IL 60614-5373

Phone

(312) 867-7090

Fax

(312) 867-7081

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert J Walsh, MD

Title

Owner/MD

Phone

(312) 867-7090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1467467142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 N MARCEY ST",
            "address_2": "SUITE 530",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145373",
            "telephone_number": "312-867-7090",
            "fax_number": "312-867-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 N MARCEY ST",
            "address_2": "SUITE 530",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145373",
            "telephone_number": "312-867-7090",
            "fax_number": "312-867-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK CENTER OF CHICAGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "312-867-7090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "36-037992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.