Organization Active NPI

Andino Chiropractic Clinic PC

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1669453056
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010991 Issued in IL
Legal business name
ANDINO CHIROPRACTIC CLINIC PC
Practice address
7264 Argus Dr
Rockford, IL 61107-5837
Phone
(815) 877-5575
Fax
(815) 877-5550
NPI assigned
Nov 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Authorized official

Name
Dr. Renee M Andino, DCNPI 1689794141
Title
President
Phone
(815) 877-5575

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 038010991 IL Primary

Addresses

Primary practice location

7264 Argus Dr
Rockford, IL 61107-5837

Mailing address

7264 Argus Dr
Rockford, IL 61107-5837
Phone (815) 877-5575

Other names 1

  • Health First Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141002000822 IL Part B Supplier - Clinic/Group Practice 7810117405 Receives reassigned benefits from 2 practitioners
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Locations

1007 W Riverside Blvd
Rockford, IL 61103
Phone (815) 877-5575

3641 N Main St
Rockford, IL 61103
Phone (815) 877-5575

Practitioners & affiliated clinicians

Practitioners 5

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": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1669453056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7264 ARGUS DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075837",
            "telephone_number": "815-877-5575",
            "fax_number": "815-877-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7264 ARGUS DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075837",
            "telephone_number": "815-877-5575",
            "fax_number": "815-877-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDINO CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "ANDINO",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-877-5575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health First Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.