NPIMap

Organization Active NPI

Spine & Joint Institute of Lake County

  • Neurology Chiropractor
  • Waukegan, IL
National Provider Identifier
1801190525
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
038010349 Issued in IL
Legal business name
SPINE & JOINT INSTITUTE OF LAKE COUNTY
Practice address
2634 Grand Ave Ste 100
Waukegan, IL 60085-2459
Phone
(847) 775-0800
Fax
(847) 775-0888
NPI assigned
Jan 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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

Authorized official

Name
Mr. Gordon SetoNPI 1194073619
Title
Clinic Director
Phone
(847) 775-0800

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
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X 038010349 IL Primary

Addresses

Primary practice location

2634 Grand Ave Ste 100
Waukegan, IL 60085-2459

Mailing address

2634 Grand Ave
Suite 100
Waukegan, IL 60085-2458
Phone (847) 775-0800

National Provider Directory

National Provider Directory

Locations

2634 Grand Ave
Ste 100
Waukegan, IL 60085
Phone (847) 775-0800

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": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1801190525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 GRAND AVE",
            "address_2": "SUITE 100",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852458",
            "telephone_number": "847-775-0800",
            "fax_number": "847-775-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 GRAND AVE STE 100",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852459",
            "telephone_number": "847-775-0800",
            "fax_number": "847-775-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & JOINT INSTITUTE OF LAKE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "SETO",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "847-775-0800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038010349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.