Revive Chiropractic & Rehabilitation Care LTD.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVIVE CHIROPRACTIC & REHABILITATION CARE LTD.

Practice address

9711 Skokie Blvd
Ste. #F
Skokie, IL 60077-1384

Phone

(773) 282-4300

Fax

(773) 282-4301

NPI assigned

Dec 22, 2009

Organization subpart

No

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

Authorized official

Name

Witold T Gozdalski, DC

Title

Owner

Phone

(773) 282-4300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1497084420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9711 SKOKIE BLVD",
            "address_2": "STE. #F",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771384",
            "telephone_number": "773-282-4300",
            "fax_number": "773-282-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 SKOKIE BLVD",
            "address_2": "STE. #F",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771384",
            "telephone_number": "773-282-4300",
            "fax_number": "773-282-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CHIROPRACTIC & REHABILITATION CARE LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "GOZDALSKI",
        "authorized_official_first_name": "WITOLD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-282-4300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Skokie, IL
• Providers in Skokie, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.