Individual provider Active NPI

Leon Robert Wleklinski, D.C.

  • Orthopedic Chiropractor
  • Park Ridge, IL
National Provider Identifier
1619970613
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
038003262 Issued in IL
Practice address
1420 Renaissance Dr
Ste 206
Park Ridge, IL 60068-1342
Phone
(847) 298-3565
Fax
(847) 298-3770
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 038003262 IL Primary

Addresses

Primary practice location

1420 Renaissance Dr
Ste 206
Park Ridge, IL 60068-1342

Mailing address

1420 Renaissance Dr
Ste 206
Park Ridge, IL 60068-1342
Phone (847) 298-3565

Other identifiers 2

IdentifierTypeStateIssuer
038003262MedicaidIL
1682237OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038003262ILMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Finnegan Family Chiropractic LTD Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1619970613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 RENAISSANCE DR",
            "address_2": "STE 206",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681342",
            "telephone_number": "847-298-3565",
            "fax_number": "847-298-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 RENAISSANCE DR",
            "address_2": "STE 206",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681342",
            "telephone_number": "847-298-3565",
            "fax_number": "847-298-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLEKLINSKI",
        "first_name": "LEON",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IL",
            "license": "038003262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038003262",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1682237",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.