Millennium Medical Group, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038009714 Issued in IL

Legal business name

MILLENNIUM MEDICAL GROUP, LLC

Doing business as

Millennium Wellness Group, LLC

Practice address

111 N Wabash Ave
Suite 600
Chicago, IL 60602-1903

Phone

(312) 332-0844

Fax

(312) 332-0847

NPI assigned

Apr 6, 2007

Last updated

Oct 18, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Lynn Beverlin, D.C.NPI 1528076825

Title

Partner

Phone

(312) 332-0844

Specialties & licenses 2

Addresses

Other names 1

• Millennium Wellness Group, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

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.

• Jennifer Lynn Beverlin, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1528076825
  Medicare reassignment Care Compare group NPD Authorized official
• Sara D Stotts, DPT

  • Physical Therapist
  • Chicago, IL
  • NPI 1760490080
  Medicare reassignment Care Compare group NPD
• Tanya Freseth, D.C.

  • Rehabilitation Chiropractor
  • Chicago, IL
  • NPI 1154746469
  NPD (past)
• Thomas Edwin Klarquist, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1477517373
  NPD (past)
• Cassandra Kramer

  • Acupuncturist
  • Chicago, IL
  • NPI 1386570752
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1659493849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-332-0844",
            "fax_number": "312-332-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-332-0844",
            "fax_number": "312-332-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "BEVERLIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "312-332-0844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009714",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millennium Wellness Group, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Millenium Park Medical Center, SC
• Millenium Wellness Center, S.C.
• Millennium Behavior Health Services
• Millennium Behavior Health Services
• Millennium Dental Specialist
• Millennium Park Dermatology, S.C.
• Millennium Park Medical Associates, S.C.
• Millennium Park Psychological Associates, LLC
• Millennium Park Smiles, LLC
• Millennium Surgical, Inc

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.