NPIMap

Organization Active NPI

Crestwood Chiropractic and Rehab

  • Chiropractor
  • Crestwood, IL
National Provider Identifier
1659461309
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CRESTWOOD CHIROPRACTIC AND REHAB
Practice address
13657 Cicero Ave
Crestwood, IL 60445-1936
Phone
(708) 396-2500
Fax
(708) 396-8605
NPI assigned
Oct 13, 2006
Last updated
Jul 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Frank Vaught, DC
Title
Owner
Phone
(708) 396-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

13657 Cicero Ave
Crestwood, IL 60445-1936

Mailing address

103B Southpointe
Edwardsville, IL 62025-3651
Phone (618) 692-9640

National Provider Directory

National Provider Directory

Locations

103 Southpointe Dr
Ste B
Edwardsville, IL 62025

Practitioners & affiliated clinicians

Practitioners 4

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1659461309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103B SOUTHPOINTE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253651",
            "telephone_number": "618-692-9640",
            "fax_number": "618-692-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13657 CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451936",
            "telephone_number": "708-396-2500",
            "fax_number": "708-396-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD CHIROPRACTIC AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "VAUGHT",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-396-2500",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.

Verify at the official NPI Registry.