Shane Michael Wade, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38010945 Issued in IL

Practice address

73 W Van Buren St
Oswego, IL 60543-7213

Phone

(630) 450-5006

NPI assigned

May 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oswego Chiropractic, LTD.

  • Chiropractor
  • Oswego, IL
  • NPI 1790983492
  Medicare reassignment NPD Authorized official
• Lisa Stout D.C., S.C.

  dba Oswego Health & Wellness Center

  • Chiropractor
  • Oswego, IL
  • NPI 1699953083
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821204223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 SALEM CIR",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 W VAN BUREN ST",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437213",
            "telephone_number": "630-450-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38010945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visionworks Inc (Visionworks)
• Sharon Vogel
• Minaxi H Vora
• Laura Anne Voruz, P.T.
• Miriam Wade
• Wainscott Therapy Services, LTD.
• Kristen Ann Wainscott, M.S., CCC-SLP
• Wal-Mart Stores, Inc. (Vision Center 30-3400)
• Walgreen Co (Walgreens #05824)
• Walgreen Co (Walgreens #01484)

• Chiropractor in Oswego, IL
• Providers in Oswego, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.