MDG P.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

038008664 Issued in IL

Legal business name

MDG P.C.

Doing business as

Sportco Rehabilitation

Practice address

83 Templeton Dr
Unit C
Oswego, IL 60543-7019

Phone

(630) 554-9991

Fax

(630) 554-9992

NPI assigned

Mar 3, 2009

Last updated

Apr 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Melanie Walker

Title

Billing Office Manager

Phone

(630) 820-9500

Specialties & licenses 1

Addresses

Other names 1

• Sportco Rehabilitation Doing business as

Locations

Practitioners 1

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.

• Amy B. Olson, DC

  • Chiropractor
  • Novi, MI
  • NPI 1265600993

  Rehabilitation

  NPD (past)

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1841430808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 SHORELINE DR",
            "address_2": "SUITE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605046108",
            "telephone_number": "630-820-9500",
            "fax_number": "630-820-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 TEMPLETON DR",
            "address_2": "UNIT C",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437019",
            "telephone_number": "630-554-9991",
            "fax_number": "630-554-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDG P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "BILLING OFFICE MANAGER",
        "authorized_official_telephone_number": "630-820-9500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038008664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sportco Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Mazeika, DDS
• Aaron McAtee
• Jaleyah McDonald
• Cherylann Marie McGovern, LCSW
• Ruth A McKindles, CRNFA
• Medivanta Diagnose LLC
• Meijer Great Lakes Limited Partnership (Meijer Pharmacy #239)
• Mental Health Abounds PLLC
• Meridian Eyecare, P.C.
• Michael T Tierney DDS.LTD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; 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.