NPIMap

Organization Active NPI

Dougherty Family Chiropractic PC

Doing business as Lifetime Health and Wellness

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1548472020
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010821 Issued in IL
Legal business name
DOUGHERTY FAMILY CHIROPRACTIC PC
Doing business as
Lifetime Health and Wellness
Practice address
11258 Il-59 #2
Naperville, IL 60564-8090
Phone
(630) 904-6700
Fax
(630) 904-6701
NPI assigned
May 4, 2007
Last updated
Aug 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Authorized official

Name
Dr. Michelle S Dougherty, D.C.NPI 1760543037
Title
President
Phone
(630) 904-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038010821 IL Primary

Addresses

Primary practice location

11258 Il-59 #2
Naperville, IL 60564-8090

Mailing address

11258 Il-59 #2
Naperville, IL 60564-8090
Phone (630) 904-6700

Other names 1

  • Lifetime Health and Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

23915 W Main St
Unit 103
Plainfield, IL 60544
Phone (815) 230-9070

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1548472020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11258 IL-59 #2",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648090",
            "telephone_number": "630-904-6700",
            "fax_number": "630-904-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11258 IL-59 #2",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648090",
            "telephone_number": "630-904-6700",
            "fax_number": "630-904-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGHERTY FAMILY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-904-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.