Northcenter Health and Wellness, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013059 Issued in IL

Legal business name

NORTHCENTER HEALTH AND WELLNESS, LLC

Practice address

4045 N Damen Ave Ste 1
Chicago, IL 60618-3277

Phone

(773) 296-2766

Fax

(773) 296-2768

NPI assigned

Mar 29, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Andy Sungsoon Park, DCNPI 1396281945

Title

Owner/Chiropractor

Phone

(847) 208-6594

Specialties & licenses 1

Addresses

Other names 1

• Northcenter Healthcare Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andy Sungsoon Park, D.C.

  • Chiropractor
  • Danville, IL
  • NPI 1396281945
  NPD Authorized official

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1790280949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 E LARCH AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600251454",
            "telephone_number": "847-208-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 N DAMEN AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183277",
            "telephone_number": "773-296-2766",
            "fax_number": "773-296-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHCENTER HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ANDY",
        "authorized_official_middle_name": "SUNGSOON",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "847-208-6594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northcenter Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Claudiana Vargas North
• Jennifer Behrens North, RDN, MBA
• Pamela D. North, CRNA
• Althea M Northage-Orr, MA, AHG, L.AC., CST
• Northcenter Chiropractic Corporation
• Northcenter Healthcare Inc
• Northeast Family Services of Illinois
• Northeast Family Services of Illinois, Inc.
• Northeast Senior Center
• Northern Illinois Clinical Laboratory, LTD.

• 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 Mar 29, 2018; 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.