Elite Chiropractic Sheboygan SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1600 Issued in WI

Legal business name

ELITE CHIROPRACTIC SHEBOYGAN SC

Doing business as

Wisconsin Spine Center

Practice address

1720 N 8TH St
Sheboygan, WI 53081-2773

Phone

(920) 803-2225

NPI assigned

Mar 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bradley D Wildberg, D.C.

Title

Owner, President

Phone

(612) 910-6600

Specialties & licenses 1

Addresses

Other names 1

• Wisconsin Spine Center Doing business as

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508998188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20456 LAKE RIDGE DR",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553727805",
            "telephone_number": "612-910-6600",
            "fax_number": "952-492-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 N 8TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530812773",
            "telephone_number": "920-803-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CHIROPRACTIC SHEBOYGAN SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILDBERG",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "612-910-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wisconsin Spine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Noah Ecclestone, OTR
• Brenda Edmunds, APNP
• Kay Eilert, RDH
• Laura Eisberner
• David M Eischen Jr., PA-C
• John L Elmendorf III, OTR/L
• Nichole M Elmendorf, OTR
• Daniel Elmes, DPM
• Embracing Cares LLC
• Carol Emerick, LPN

• Chiropractor in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.