Organization Active NPI

La Clinica, S.C.

  • Chiropractor
  • Cicero, IL
National Provider Identifier
1679641930
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LA CLINICA, S.C.
Practice address
5832 W Cermak Rd
Cicero, IL 60804-2133
Phone
(708) 329-0039
Fax
(708) 329-0040
NPI assigned
Dec 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eugene Mario Jao, DCNPI 1356310833
Title
Ceo
Phone
(708) 329-0039

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 IL Primary

Addresses

Primary practice location

5832 W Cermak Rd
Cicero, IL 60804-2133

Mailing address

5832 W Cermak Rd
Cicero, IL 60804-2133
Phone (708) 329-0039

National Provider Directory

National Provider Directory

Locations

5832 W Cermak Rd
Cicero, IL 60804
Phone (312) 203-3372

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1165017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679641930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5832 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042133",
            "telephone_number": "708-329-0039",
            "fax_number": "708-329-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042133",
            "telephone_number": "708-329-0039",
            "fax_number": "708-329-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAO",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "MARIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-329-0039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.