Organization Active NPI

Zen Physical Medicine LTD

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1467533497
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009452 Issued in IL
Legal business name
ZEN PHYSICAL MEDICINE LTD
Practice address
5301 E State St
Suite112
Rockford, IL 61108-2388
Phone
(815) 395-8676
Fax
(815) 395-1751
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Dr. Christine Marian, D.C.NPI 1023095155
Title
President
Phone
(815) 395-8676

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 038009452 IL Primary

Addresses

Primary practice location

5301 E State St
Suite112
Rockford, IL 61108-2388

Mailing address

5301 E State St
Suite112
Rockford, IL 61108-2901
Phone (815) 395-8676

Other identifiers 2

IdentifierTypeStateIssuer
1023095155OtherILINDIVIDUAL NPI #
038-009452OtherILCHIROPRACTIC LICENSE #

National Provider Directory

National Provider Directory

Locations

2222 E State St
Ste 105
Rockford, IL 61104
Phone (815) 395-8676

5301 E State St
Ste 112
Rockford, IL 61108
Phone (815) 395-8676

Practitioners & affiliated clinicians

Practitioners 2

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": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1467533497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E STATE ST",
            "address_2": "SUITE112",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082901",
            "telephone_number": "815-395-8676",
            "fax_number": "815-395-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E STATE ST",
            "address_2": "SUITE112",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082388",
            "telephone_number": "815-395-8676",
            "fax_number": "815-395-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZEN PHYSICAL MEDICINE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "MARIAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-395-8676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1023095155",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE #",
            "identifier": "038-009452",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.