NPIMap

Organization Active NPI

Superior Health and Wellness of Crystal Lake, LTD.

  • Physical Medicine & Rehabilitation Physician
  • Crystal Lake, IL
National Provider Identifier
1811266554
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SUPERIOR HEALTH AND WELLNESS OF CRYSTAL LAKE, LTD.
Practice address
6119 Northwest Hwy Ste B
Crystal Lake, IL 60014-7911
Phone
(815) 477-8844
Fax
(815) 308-3387
NPI assigned
Dec 27, 2011
Last updated
Apr 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Dr. Jill E Howe, DCNPI 1699888347
Title
President
Phone
(815) 477-8844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

6119 Northwest Hwy Ste B
Crystal Lake, IL 60014-7911

Mailing address

6119-B Northwest Highway
Crystal Lake, IL 60014
Phone (815) 477-8844

National Provider Directory

National Provider Directory

Locations

6119 N West Hwy
#B
Crystal Lake, IL 60014
Phone (815) 477-8844

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1811266554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6119-B NORTHWEST HIGHWAY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-477-8844",
            "fax_number": "815-308-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6119 NORTHWEST HWY STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147911",
            "telephone_number": "815-477-8844",
            "fax_number": "815-308-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR HEALTH AND WELLNESS OF CRYSTAL LAKE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "HOWE",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-477-8844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

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