Neck and Back Clinic, LTD.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

NECK AND BACK CLINIC, LTD.

Practice address

4176 West Montrose Ave
Chicago, IL 60641-2161

Phone

(773) 283-3131

Fax

(773) 283-0793

NPI assigned

Apr 17, 2007

Last updated

Aug 22, 2020By 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

Dr. Derrick David Wallery, D.C.NPI 1437311701

Title

President

Phone

(773) 283-3131

Specialties & licenses 1

Addresses

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.

• Derrick D Wallery, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1437311701
  Authorized official Same address or phone

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730305913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4176 WEST MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412161",
            "telephone_number": "773-283-3131",
            "fax_number": "773-283-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4176 WEST MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412161",
            "telephone_number": "773-283-3131",
            "fax_number": "773-283-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NECK AND BACK CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLERY",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-283-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Neborak, M.D.
• Nebula Transportation Services LLC
• Tina Necasek, R.PH.
• Jenna Louise Nechamen, MOT, OTR/L
• Jonathan W Necheles, MD MPH
• Sergey Neckrysh, MD
• Evan William Neczypor, MD
• Rashmi Nedadur, MD
• Jenna Nedbalek, LCSW
• Thomas Robert Nedderman, CRC, LPC

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor 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.