Active Life Chiropractic Center, LTD.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

038008780 Issued in IL

Legal business name

ACTIVE LIFE CHIROPRACTIC CENTER, LTD.

Practice address

10761 163Rd PL
Orland Park, IL 60467-8861

Phone

(708) 403-9450

Fax

(708) 403-9488

NPI assigned

May 30, 2007

Last updated

Sep 6, 2011By 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

Dr. Laura Jendra, D.C.NPI 1992716930

Title

Owner

Phone

(708) 403-9450

Specialties & licenses 1

Addresses

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.

• Laura Jendra, D.C.

  • Sports Physician Chiropractor
  • Orland Park, IL
  • NPI 1992716930
  Authorized official Same address or phone

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1841491677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10761 163RD PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678861",
            "telephone_number": "708-403-9450",
            "fax_number": "708-403-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10761 163RD PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678861",
            "telephone_number": "708-403-9450",
            "fax_number": "708-403-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE CHIROPRACTIC CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "JENDRA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-403-9450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "038008780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nour Abughoush
• Saed Abughoush, DMD
• Faris F Abusharif, MD
• Accelerated Rehabilitation Centers, LTD (Athletico Physical Therapy)
• Acdi Orland Park LLC
• Active Physical Therapy & Rehabilitation P.C.
• Natalie Adair, LCSW
• Lorenda Faye Adams, MHS, CCC-SLP
• Nichole Addo-Stover, COTA
• Martins Adeoye, MD

• Clinic/Center in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.