Individual provider Active NPI

Jesse Michael Lang, D.C,

  • Chiropractor
  • Shorewood, IL
National Provider Identifier
1821311101
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011635 Issued in IL
Practice address
900 Geneva St
Shorewood, IL 60404-9403
Phone
(815) 436-1988
Fax
(815) 436-2278
NPI assigned
Mar 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011635 IL Primary

Addresses

Primary practice location

900 Geneva St
Shorewood, IL 60404-9403

Mailing address

900 Geneva St
Shorewood, IL 60404-9403
Phone (815) 436-1988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011635ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
MWH S.C. Chiropractor CurrentSince Jul 24, 2022 Accepting new patients

Locations

900 Geneva St
Shorewood, IL 60404
Phone (815) 436-1988

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1821311101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 GENEVA ST",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604049403",
            "telephone_number": "815-436-1988",
            "fax_number": "815-436-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 GENEVA ST",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604049403",
            "telephone_number": "815-436-1988",
            "fax_number": "815-436-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "credential": "D.C,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-01",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.