NPIMap

Organization Active NPI

Coleman Wellness SC

  • Chiropractor
  • Yorkville, IL
National Provider Identifier
1629507819
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038004818 Issued in IL
Legal business name
COLEMAN WELLNESS SC
Practice address
129 Commercial Dr Unit 5B
Yorkville, IL 60560-4731
Phone
(630) 553-7600
NPI assigned
Jun 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Dr. Bruce Robert Coleman, D.C.NPI 1871698977
Title
President
Phone
(630) 553-7600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038004818 IL Primary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X

Addresses

Primary practice location

129 Commercial Dr Unit 5B
Yorkville, IL 60560-4731

Mailing address

PO Box 156
Yorkville, IL 60560-0156
Phone (630) 553-7600

Other identifiers 1

IdentifierTypeStateIssuer
11895142OtherCAQH

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, 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": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1629507819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605600156",
            "telephone_number": "630-553-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 COMMERCIAL DR UNIT 5B",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605604731",
            "telephone_number": "630-553-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMAN WELLNESS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-553-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004818",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11895142",
            "state": null
        }
    ],
    "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 Sep 15, 2023; 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.