NPIMap

Organization Active NPI

Pro Sports and Spinal Rehab

  • Chiropractor
  • Plainfield, IL
National Provider Identifier
1770905432
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011835 Issued in IL
Legal business name
PRO SPORTS AND SPINAL REHAB
Practice address
12337 S Route 59
Unit 119
Plainfield, IL 60585-4625
Phone
(815) 267-6263
Fax
(815) 782-8549
NPI assigned
Jan 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Authorized official

Name
Mr. Randal Cybulski, DCNPI 1063717676
Title
Owner
Phone
(815) 267-6263

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038011835 IL Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 070006640 IL

Addresses

Primary practice location

12337 S Route 59
Unit 119
Plainfield, IL 60585-4625

Mailing address

12337 S Route 59
Unit 119
Plainfield, IL 60585-4625
Phone (815) 267-6263

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426204800000",
    "number": "1770905432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12337 S ROUTE 59",
            "address_2": "UNIT 119",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605854625",
            "telephone_number": "815-267-6263",
            "fax_number": "815-782-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12337 S ROUTE 59",
            "address_2": "UNIT 119",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605854625",
            "telephone_number": "815-267-6263",
            "fax_number": "815-782-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO SPORTS AND SPINAL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2015-03-13",
        "status": "A",
        "authorized_official_last_name": "CYBULSKI",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-267-6263",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011835",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070006640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.