NPIMap

Organization Active NPI

Chiro One Wellness Center Metro of Lincoln Square LLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1619268778
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER METRO OF LINCOLN SQUARE LLC
Practice address
4725 N. Western Ave
Ste 280
Chicago, IL 60625-3499
Phone
(773) 754-3838
Fax
(773) 754-3841
NPI assigned
Apr 25, 2011
Last updated
Nov 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Authorized official

Name
Sam WangNPI 1073520136
Title
Coo
Phone
(630) 468-1824

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

4725 N. Western Ave
Ste 280
Chicago, IL 60625-3499

Mailing address

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234
Phone (630) 320-6400

National Provider Directory

National Provider Directory

Locations

4725 N Western Ave
Ste 280
Chicago, IL 60625
Phone (773) 754-3838

7789 Solutions Ctr
Chicago, IL 60677

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": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1619268778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-320-6400",
            "fax_number": "630-320-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N. WESTERN AVE",
            "address_2": "STE 280",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253499",
            "telephone_number": "773-754-3838",
            "fax_number": "773-754-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER METRO OF LINCOLN SQUARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-468-1824"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.