NPIMap

Organization Active NPI

Advanced Wellness Chiropractic and Functional Rehab LLC

Doing business as Advanced Wellness

  • Chiropractor
  • Alton, IL
National Provider Identifier
1629377650
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011560 Issued in IL
Legal business name
ADVANCED WELLNESS CHIROPRACTIC AND FUNCTIONAL REHAB LLC
Doing business as
Advanced Wellness
Practice address
231 E Delmar Rd
Alton, IL 62002-5935
Phone
(618) 462-6630
Fax
(618) 462-6640
NPI assigned
Mar 16, 2011
Last updated
Mar 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Dr. Kyle Anthony Buesteton, DCNPI 1760712244
Title
Doctor of Chiropractic/ Owner
Phone
(618) 462-6630

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 038.011560 IL Primary

Addresses

Primary practice location

231 E Delmar Rd
Alton, IL 62002-5935

Mailing address

231 E Delmar Rd
Alton, IL 62002-5935
Phone (618) 462-6630

Other names 1

  • Advanced Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

231 E Delmar Rd
Alton, IL 62002
Phone (618) 462-6630

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1629377650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 E DELMAR RD",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025935",
            "telephone_number": "618-462-6630",
            "fax_number": "618-462-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E DELMAR RD",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025935",
            "telephone_number": "618-462-6630",
            "fax_number": "618-462-6640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WELLNESS CHIROPRACTIC AND FUNCTIONAL REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "BUESTETON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC/ OWNER",
        "authorized_official_telephone_number": "618-462-6630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.