Dr Thomas J Solecki Jr SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3590 Issued in WI

Legal business name

DR THOMAS J SOLECKI JR SC

Doing business as

Sports & Family Chiropractic Clinic

Practice address

6123 Green Bay Rd
Suite 140
Kenosha, WI 53142-2927

Phone

(262) 653-9208

Fax

(262) 653-9264

NPI assigned

Sep 19, 2005

Last updated

Sep 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Elizabeth Counterman

Title

Business Manager

Phone

(262) 925-9000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Sports & Family Chiropractic Clinic Doing business as

Practitioners 1

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.

• Tarey Ann Wenninger, P.T.,

  • Physical Therapist
  • Kenosha, WI
  • NPI 1053468397
  NPD (past)

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1629063458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531410158",
            "telephone_number": "262-925-9000",
            "fax_number": "262-925-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 GREEN BAY RD",
            "address_2": "SUITE 140",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422927",
            "telephone_number": "262-653-9208",
            "fax_number": "262-653-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR THOMAS J SOLECKI JR SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "COUNTERMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "262-925-9000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3590",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WI",
            "identifier": "398964451007",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38910800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports & Family Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dr. Birute Balciunas
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• Dr. Rand Lee, SC
• Eddie Dragovoja, PTA
• Ann Drechsler, LCSW

• Chiropractor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.