Organization Active NPI

At Ease Wellness Center LLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1710063102
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009989 Issued in IL
Legal business name
AT EASE WELLNESS CENTER LLC
Practice address
4403 N. Broadway St.
Chicago, IL 60640
Phone
(773) 561-7966
Fax
(773) 561-7923
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Dr. Christopher Evans, D.C.
Title
Chief Executive Officer/Chiropracti
Phone
(773) 561-7966

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038009989 IL Primary

Addresses

Primary practice location

4403 N. Broadway St.
Chicago, IL 60640

Mailing address

4403 N Broadway St
Chicago, IL 60640
Phone (773) 561-7966

National Provider Directory

National Provider Directory

Locations

1437 W Montrose Ave
Chicago, IL 60613
Phone (773) 561-7966

Practitioners & affiliated clinicians

Practitioners 2

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": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1710063102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-561-7966",
            "fax_number": "773-561-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 N. BROADWAY ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-561-7966",
            "fax_number": "773-561-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT EASE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER/CHIROPRACTI",
        "authorized_official_telephone_number": "773-561-7966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 28, 2010; 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.