NPIMap

Organization Active NPI

Edgerwater Rehilitation & Wellness Center, Inc.

  • Chiropractor
  • Mundelein, IL
National Provider Identifier
1487981874
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008417 Issued in IL
Legal business name
EDGERWATER REHILITATION & WELLNESS CENTER, INC.
Practice address
545 N Lake St
Mundelein, IL 60060-1826
Phone
(815) 404-3727
NPI assigned
Nov 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Authorized official

Name
Wendy Kust
Title
Office Manager
Phone
(815) 404-3727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038008417 IL Primary

Addresses

Primary practice location

545 N Lake St
Mundelein, IL 60060-1826

Mailing address

7 Sherwood CT
Lake in the Hills, IL 60156-5929
Phone (815) 404-3727

National Provider Directory

National Provider Directory
Tax ID family
Edgerwater Rehilitation Wellness Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257465600000",
    "number": "1487981874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SHERWOOD CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565929",
            "telephone_number": "815-404-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N LAKE ST",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601826",
            "telephone_number": "815-404-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGERWATER REHILITATION & WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A",
        "authorized_official_last_name": "KUST",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "815-404-3727"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.