Individual provider Active NPI

Jennifer Lea Wise, D.C.

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1699811471
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009021 Issued in IL
Practice address
4931 S Route 59
Unit 121
Naperville, IL 60564-5705
Phone
(630) 355-8022
Fax
(630) 355-8032
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038009021 IL Primary

Addresses

Primary practice location

4931 S Route 59
Unit 121
Naperville, IL 60564-5705

Mailing address

4931 S Route 59
Unit 121
Naperville, IL 60564-5705
Phone (630) 355-8022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602000736 IL Practitioner - Chiropractic 2062454085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4931 S Route 59
Suite 119
Naperville, IL 60564-2692
Phone (630) 355-8022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Acupuncture & Chiropractic Inc. CurrentSince Sep 26, 2023 Accepting new patients

Locations

4931 S Route 59
Ste 119
Naperville, IL 60564
Phone (630) 355-8022

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1699811471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4931 S ROUTE 59",
            "address_2": "UNIT 121",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645705",
            "telephone_number": "630-355-8022",
            "fax_number": "630-355-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4931 S ROUTE 59",
            "address_2": "UNIT 121",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645705",
            "telephone_number": "630-355-8022",
            "fax_number": "630-355-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JENNIFER",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.