Active NPI
Ryan Matthew Wuebben, DC
- Chiropractor
- Shorewood, IL
National Provider Identifier
1639258643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Practice address
- 568 Brook Forest Ave.
Shorewood, IL 60404 - Phone
- (815) 725-5733
- Fax
- (815) 725-5722
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Primary |
Addresses
Primary practice location
568 Brook Forest Ave.
Shorewood, IL 60404
Mailing address
25240 Balmoral Dr
Shorewood, IL 60431-8371
Phone (563) 340-3337
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
| License | State | Type | Specialty |
|---|---|---|---|
| 038-010057 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639258643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25240 BALMORAL DR",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604318371",
"telephone_number": "563-340-3337",
"fax_number": "815-725-5722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "568 BROOK FOREST AVE.",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "60404",
"telephone_number": "815-725-5733",
"fax_number": "815-725-5722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUEBBEN",
"first_name": "RYAN",
"middle_name": "MATTHEW",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.