Elite Spine & Wellness Center, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ELITE SPINE & WELLNESS CENTER, INC

Practice address

6833 Stalter Dr Ste 203
Rockford, IL 61108-2582

Phone

(815) 904-6650

Fax

(815) 904-6564

NPI assigned

Oct 8, 2020

Organization subpart

No

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

Authorized official

Name

Brittany Sullivan, DCNPI 1629311261

Title

Owner

Phone

(181) 598-8783

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brittany Sullivan, D. C.

  • Chiropractor
  • Rockford, IL
  • NPI 1629311261
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611100800000",
    "number": "1568069805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6833 STALTER DR STE 203",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082582",
            "telephone_number": "815-904-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6833 STALTER DR STE 203",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082582",
            "telephone_number": "815-904-6650",
            "fax_number": "815-904-6564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5898 Pathfinder Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611094008",
            "country_code": "US",
            "telephone_number": "815-988-7831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE SPINE & WELLNESS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "181-598-8783",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Augusta Eldridge, ATC, CSCS
• Elemental ABA
• Elevated Health Essentials, LLC
• Elevated Health LLC Dba Brightstar Care of Rockford
• Elgin Physical Medicine SC
• Elizabeth Lawson LCSW PLLC
• Theodore Eller, M.D.
• Antoinette Gail Ellingson, C.N.P.
• Cynthia Gail Elliott-Zippe, APN
• Constance J Ellis, LMT

• Clinic/Center in Rockford, IL
• Providers in Rockford, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.