Wyatt Winn

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.014254 Issued in IL

Practice address

11124 Front St
Mokena, IL 60448-1525

Phone

(708) 478-9850

Fax

(630) 812-0780

NPI assigned

Jan 20, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Wellness LLCGroup PAC ID 3072752864, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Active Wellness, LLC

  • Chiropractor
  • Chicago, IL
  • NPI 1902162662
  Medicare reassignment Care Compare group NPD
• Healthsource of Downtown Mokena

  • Chiropractor
  • Mokena, IL
  • NPI 1598456618
  Medicare reassignment NPD
• Active Wellness LLC

  • Chiropractor
  • Chicago, IL
  • NPI 1891120408
  NPD

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1528879327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11124 FRONT ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481525",
            "telephone_number": "708-478-9850",
            "fax_number": "630-812-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11124 FRONT ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481525",
            "telephone_number": "708-478-9850",
            "fax_number": "630-812-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINN",
        "first_name": "WYATT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.014254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebonie Leah Williams, FNP-BC
• Valerie Williams, P.T., D.P.T.
• Eleanor Grace Wilson
• Krystal Wilson
• Kimberly S Winkelman, BCBA
• Wirth Counseling Services, P.C.
• Denise A Wirth, LCPC
• Leon Joseph Witkowski III, DDS
• Riley Ann Wlos
• Sandra Wood, APN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.