Organization Active NPI

Comprehensive Chiropractic LLC

  • Chiropractor
  • Buffalo Grove, IL
National Provider Identifier
1629096078
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
COMPREHENSIVE CHIROPRACTIC LLC
Practice address
1411 McHenry Rd
Suite 225
Buffalo Grove, IL 60089-1385
Phone
(874) 727-6278
Fax
(847) 276-2785
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Irene D Wallace, D.C.NPI 1639122658
Title
Doctor of Chiropractic
Phone
(847) 276-2785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X IL Primary

Addresses

Primary practice location

1411 McHenry Rd
Suite 225
Buffalo Grove, IL 60089-1385

Mailing address

1411 McHenry Rd
Suite 225
Buffalo Grove, IL 60089-1385
Phone (874) 727-6278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060803000010 IL Part B Supplier - Clinic/Group Practice 1355354689 Receives reassigned benefits from 1 practitioner
Practice locations: Buffalo Grove, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629096078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 MCHENRY RD",
            "address_2": "SUITE 225",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891385",
            "telephone_number": "874-727-6278",
            "fax_number": "847-276-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MCHENRY RD",
            "address_2": "SUITE 225",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891385",
            "telephone_number": "874-727-6278",
            "fax_number": "847-276-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "847-276-2785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.