Promed Chiropractic Institute P.C.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

PROMED CHIROPRACTIC INSTITUTE P.C.

Practice address

454 W Boughton Rd
Suite B
Bolingbrook, IL 60440-1378

Phone

(630) 226-9908

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. George Papadopoulos, D.C., LAT, RKT

Title

President

Phone

(630) 226-5754

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699896787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 W BOUGHTON RD",
            "address_2": "SUITE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401378",
            "telephone_number": "630-226-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 W BOUGHTON RD",
            "address_2": "SUITE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401378",
            "telephone_number": "630-226-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED CHIROPRACTIC INSTITUTE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAPADOPOULOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-226-5754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., LAT, RKT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09932151",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Clinic/Center in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Rehabilitation Clinic/Center in Illinois

• 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.