NPIMap

Organization Active NPI

Serenity Integrative Medicine LTD

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1699117531
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SERENITY INTEGRATIVE MEDICINE LTD
Doing business as
Spine & Sports Center of Chicago
Practice address
600 W Fulton St
Suite 304
Chicago, IL 60661-1259
Phone
(312) 756-1778
NPI assigned
Jul 19, 2013
Organization subpart
Yes
Parent organization
SERENITY INTEGRATIVE MEDICINE LTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Authorized official

Name
Thomas Lotus, D.C.
Title
President
Phone
(312) 756-1778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

600 W Fulton St
Suite 304
Chicago, IL 60661-1259

Mailing address

430 W Erie St
Suite 403
Chicago, IL 60654-6914
Phone (312) 898-6327

Other names 1

  • Spine & Sports Center of Chicago Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140411000502 IL Part B Supplier - Clinic/Group Practice 0143452839 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory
Part of
Serenity Integrative Medicine LTD

Locations

430 W Erie St
Ste 603
Chicago, IL 60654
Phone (312) 846-6647

Practitioners & affiliated clinicians

Practitioners 4

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": "1374192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1699117531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "SUITE 403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546914",
            "telephone_number": "312-898-6327",
            "fax_number": "312-846-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W FULTON ST",
            "address_2": "SUITE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611259",
            "telephone_number": "312-756-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY INTEGRATIVE MEDICINE LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SERENITY INTEGRATIVE MEDICINE LTD.",
        "enumeration_date": "2013-07-19",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "LOTUS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-756-1778",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine & Sports Center of Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.