Organization Active NPI

Chiro One Wellness Center of Des Plaines LLC

  • Chiropractor
  • Des Plaines, IL
National Provider Identifier
1740451657
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER OF DES PLAINES LLC
Practice address
1460 Market St Ste 204
Des Plaines, IL 60016-4643
Phone
(224) 567-6160
Fax
(630) 468-1478
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Dr. Sam WangNPI 1073520136
Title
Coo
Phone
(630) 468-1824

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1460 Market St Ste 204
Des Plaines, IL 60016-4643

Mailing address

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080627000575 IL Part B Supplier - Clinic/Group Practice 8426120957 Receives reassigned benefits from 1 practitioner
Practice locations: Des Plaines, IL

National Provider Directory

National Provider Directory

Locations

1460 Market St
Ste 204
Des Plaines, IL 60016
Phone (224) 567-6160

Practitioners & affiliated clinicians

Practitioners 4

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": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1740451657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-468-1824",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MARKET ST STE 204",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164643",
            "telephone_number": "224-567-6160",
            "fax_number": "630-468-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF DES PLAINES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-468-1824",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.