Chiro One Wellness Center of Edwardsville, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHIRO ONE WELLNESS CENTER OF EDWARDSVILLE, LLC

Practice address

6654 Edwardsville Crossing Dr Ste H
Edwardsville, IL 62025-2706

Phone

(630) 468-1824

NPI assigned

Nov 18, 2019

Organization subpart

No

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

Authorized official

Name

Sam Wang

Title

Coo

Phone

(630) 468-1824

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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

• Janay Collier, DC

  • Chiropractor
  • Danville, IL
  • NPI 1508488867
  Medicare reassignment NPD
• Stuart Bernsen, D.C.

  • Chiropractor
  • Evanston, IL
  • NPI 1386691566
  NPD (past)
• Anthony Abdul Deneal

  • Chiropractor
  • Oak Brook, IL
  • NPI 1457384372
  NPD (past)

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1831735521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6654 EDWARDSVILLE CROSSING DR STE H",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252706",
            "telephone_number": "630-468-1824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6654 Edwardsville Crossing Dr Ste H",
            "address_purpose": "LOCATION",
            "city": "Edwardsville",
            "state": "IL",
            "postal_code": "620252706",
            "country_code": "US",
            "telephone_number": "630-468-1824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF EDWARDSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-468-1824"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Gabrielle Chapman
• Chatterbox Speech, LLC
• Lauren Chenoweth
• Chestnut Health Systems, Inc.
• Childrens Illinois Inc
• Chiropractic Care Center
• Amber N Cholevik
• Christian Hospital Illinois Services
• Mickey Charles Christian
• Christina J. Levi O D P C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.