NPIMap

Organization Active NPI

Modern Health & Body Inc

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1841604386
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011455 Issued in IL
Legal business name
MODERN HEALTH & BODY INC
Doing business as
Northcenter Healthcare
Practice address
4045 N Damen Ave
Suite 1
Chicago, IL 60618-3148
Phone
(773) 296-2766
NPI assigned
Jun 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Dr. Krysten Tatarek, DC
Title
President
Phone
(773) 782-7410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038011455 IL Primary

Addresses

Primary practice location

4045 N Damen Ave
Suite 1
Chicago, IL 60618-3148

Mailing address

4045 N Damen Ave
Suite 1
Chicago, IL 60618-3148
Phone (773) 296-2766

Other names 1

  • Northcenter Healthcare Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1841604386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 N DAMEN AVE",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183148",
            "telephone_number": "773-296-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 N DAMEN AVE",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183148",
            "telephone_number": "773-296-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HEALTH & BODY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "TATAREK",
        "authorized_official_first_name": "KRYSTEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-782-7410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northcenter Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.