Organization Active NPI

Stretchclub S.C.

  • Chiropractor
  • Yorkville, IL
National Provider Identifier
1619500428
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
STRETCHCLUB S.C.
Practice address
332 E Veterans Pkwy
Yorkville, IL 60560-1767
Phone
(630) 882-9695
NPI assigned
Feb 20, 2020
Last updated
May 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Mark Glynn, DC
Title
Employee
Phone
(630) 882-9695

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

332 E Veterans Pkwy
Yorkville, IL 60560-1767

Mailing address

332 E Veterans Pkwy
Yorkville, IL 60560-1767
Phone (630) 882-9695

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1619500428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 E VETERANS PKWY",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601767",
            "telephone_number": "630-882-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 E VETERANS PKWY",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601767",
            "telephone_number": "630-882-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRETCHCLUB S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "GLYNN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "630-882-9695",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.