Deep Roots Chiropractic & Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DEEP ROOTS CHIROPRACTIC & WELLNESS CENTER LLC

Practice address

6178 N Northwest Hwy
Chicago, IL 60631-2126

Phone

(773) 570-6404

NPI assigned

May 11, 2023

Last updated

Aug 21, 2023By 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. Kevin Patrick Reider, DCNPI 1114616802

Title

Doctor of Chiropractic

Phone

(773) 570-6404

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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.

• Kevin Patrick Reider, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1114616802
  Medicare reassignment NPD Authorized official
• Christina Drinka

  • Massage Therapist
  • Chicago, IL
  • NPI 1962286294
  NPD
• Amanda Marie Pade

  • Massage Therapist
  • Chicago, IL
  • NPI 1235817180
  NPD
• Jenee Rose, MT

  • Massage Therapist
  • Chicago, IL
  • NPI 1326822024
  NPD

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1750071874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6178F N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312126",
            "telephone_number": "773-570-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6178 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312126",
            "telephone_number": "773-570-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP ROOTS CHIROPRACTIC & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "REIDER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "773-570-6404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Declan Michael Deely, LSW
• Susan Deems-Dluhy, PT
• Deen Health System LLC
• Surrin Shazam Deen
• Vaishali Deenadayalan, MD
• Shara Deepankar, BCBA
• Deeply Rooted Nutrition LLC
• Deeply Rooted Therapeutic Solutions LLC
• Deer Rehabilitation Services Inc
• Deer Rehabilitation Services Inc

• 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 21, 2023; 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.