Organization Active NPI

Advanced Sport and Wellness LTD

  • Chiropractor
  • Wheaton, IL
National Provider Identifier
1699244848
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ADVANCED SPORT AND WELLNESS LTD
Practice address
1776 S Naperville Rd Ste 200
Wheaton, IL 60189-5831
Phone
(630) 791-0058
NPI assigned
Nov 16, 2018
Last updated
May 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Christopher Kudyba, D.C.NPI 1235571084
Title
Chiropractor
Phone
(630) 791-0058

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
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1776 S Naperville Rd Ste 200
Wheaton, IL 60189-5831

Mailing address

1776 S Naperville Rd Ste 200
Wheaton, IL 60189-5831
Phone (630) 791-0058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190107002204 IL Part B Supplier - Clinic/Group Practice 5193061547 Receives reassigned benefits from 1 practitioner
Practice locations: Naperville, IL

National Provider Directory

National Provider Directory

Locations

1805 N Mill St
Ste E
Naperville, IL 60563
Phone (630) 791-0058

1776 S Naperville Rd
Ste 200
Wheaton, IL 60189
Phone (630) 791-0058

Practitioners & affiliated clinicians

Practitioners 1

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": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1699244848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 S NAPERVILLE RD STE 200",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895831",
            "telephone_number": "630-791-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 S NAPERVILLE RD STE 200",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895831",
            "telephone_number": "630-791-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPORT AND WELLNESS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-16",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "KUDYBA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "630-791-0058",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.