Active NPI
Joseph Chuka Wabomnor, DC
- Chiropractor
- Chicago, IL
National Provider Identifier
1487746301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038009465
- Practice address
- 2075 N Western Ave
Chicago, IL 60647-4167 - Phone
- (773) 252-0800
- Fax
- (773) 252-0881
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038009465 | IL | Primary |
Addresses
Primary practice location
2075 N Western Ave
Chicago, IL 60647-4167
Mailing address
2075 N Western Ave
Chicago, IL 60647-4167
Phone (773) 252-0800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1627996 | Other | BCBS IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038009465 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1487746301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2075 N WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606474167",
"telephone_number": "773-252-0800",
"fax_number": "773-252-0881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2075 N WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606474167",
"telephone_number": "773-252-0800",
"fax_number": "773-252-0881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WABOMNOR",
"first_name": "JOSEPH",
"middle_name": "CHUKA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038009465",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IL",
"identifier": "1627996",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.