NPIMap

Organization Active NPI

Sportco Rehabilitation PC

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1740465723
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008664 Issued in IL
Legal business name
SPORTCO REHABILITATION PC
Practice address
1995 Springbrook Square Dr
Unit 109
Naperville, IL 60564-5951
Phone
(630) 922-6500
Fax
(630) 922-6502
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Dr. Mark Glynn, D.C.NPI 1174655328
Title
Owner
Phone
(630) 922-6500

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 038008664 IL Primary

Addresses

Primary practice location

1995 Springbrook Square Dr
Unit 109
Naperville, IL 60564-5951

Mailing address

1995 Springbrook Square Dr.
Unit 109
Naperville, IL 60564-5951
Phone (630) 922-6500

National Provider Directory

National Provider Directory

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": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1740465723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 SPRINGBROOK SQUARE DR.",
            "address_2": "UNIT 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645951",
            "telephone_number": "630-922-6500",
            "fax_number": "630-922-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 SPRINGBROOK SQUARE DR",
            "address_2": "UNIT 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645951",
            "telephone_number": "630-922-6500",
            "fax_number": "630-922-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTCO REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "GLYNN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-922-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.