Energize Chiropractic, Prof Corp

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038012010 Issued in IL

Legal business name

ENERGIZE CHIROPRACTIC, PROF CORP

Practice address

365 E Bailey Rd
Naperville, IL 60565-1415

Phone

(630) 536-8002

NPI assigned

Oct 4, 2011

Last updated

Oct 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Ford

Title

President

Phone

(920) 562-2705

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1720362106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 E BAILEY RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 E BAILEY RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651415",
            "telephone_number": "630-536-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGIZE CHIROPRACTIC, PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-562-2705"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Naperville, IL
• Providers in Naperville, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.