Organization Active NPI

Applied Wellness Center SC

  • Nutrition Chiropractor
  • Palos Heights, IL
National Provider Identifier
1487722716
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
038.008810 Issued in IL
Legal business name
APPLIED WELLNESS CENTER SC
Practice address
13301 S Ridgeland Ave
Ste a
Palos Heights, IL 60463-0030
Phone
(708) 489-3700
Fax
(708) 489-3705
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Authorized official

Name
Janelle Pattara
Title
Biller
Phone
(630) 890-2758

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X 038008810 IL
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X 038.008810 IL Primary

Addresses

Primary practice location

13301 S Ridgeland Ave
Ste a
Palos Heights, IL 60463-0030

Mailing address

13301 S Ridgeland Ave
Ste a
Palos Heights, IL 60463-0030
Phone (708) 489-3700

Other identifiers 2

IdentifierTypeStateIssuer
210819OtherILMC PROVIDER #
09927458OtherILBCBS

National Provider Directory

National Provider Directory

Locations

13301 S Ridgeland Ave
Unit A
Palos Heights, IL 60463
Phone (708) 489-3700

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313366400000",
    "number": "1487722716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13301 S RIDGELAND AVE",
            "address_2": "STE A",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604630030",
            "telephone_number": "708-489-3700",
            "fax_number": "708-489-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 S RIDGELAND AVE",
            "address_2": "STE A",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604630030",
            "telephone_number": "708-489-3700",
            "fax_number": "708-489-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLIED WELLNESS CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-08-15",
        "status": "A",
        "authorized_official_last_name": "PATTARA",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "630-890-2758"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": "038008810",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": "038.008810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC PROVIDER #",
            "identifier": "210819",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09927458",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.