Organization Active NPI

Victory Rehab, LLC

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1649614199
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011320 Issued in IL
Legal business name
VICTORY REHAB, LLC
Practice address
1300 Iroquois Ave
270
Naperville, IL 60563-8553
Phone
(630) 857-3704
Fax
(888) 891-5022
NPI assigned
Apr 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Christopher Kessler, D.C.NPI 1457599029
Title
President
Phone
(630) 857-3704

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 038.011320 IL Primary

Addresses

Primary practice location

1300 Iroquois Ave
270
Naperville, IL 60563-8553

Mailing address

1300 Iroquois Ave
270
Naperville, IL 60563-8553
Phone (630) 857-3704

Other identifiers 1

IdentifierTypeStateIssuer
038.011320OtherILSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130715000549 IL Part B Supplier - Clinic/Group Practice 8325288343 Receives reassigned benefits from 1 practitioner
Practice locations: Naperville, IL

National Provider Directory

National Provider Directory

Locations

1300 Iroquois Ave
Ste 270
Naperville, IL 60563
Phone (630) 428-0201

Practitioners & affiliated clinicians

Practitioners 2

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": "1366848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1649614199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 IROQUOIS AVE",
            "address_2": "270",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638553",
            "telephone_number": "630-857-3704",
            "fax_number": "888-891-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 IROQUOIS AVE",
            "address_2": "270",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638553",
            "telephone_number": "630-857-3704",
            "fax_number": "888-891-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "KESSLER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-857-3704",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "038.011320",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.