Organization Active NPI

One Goal Wellness, Inc

  • Chiropractor
  • Lake Villa, IL
National Provider Identifier
1861894081
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012071 Issued in IL
Legal business name
ONE GOAL WELLNESS, INC
Practice address
36735 N. Il 83
Ste D
Lake Villa, IL 60046
Phone
(847) 265-5600
Fax
(847) 245-4491
NPI assigned
Sep 18, 2014
Last updated
May 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Dr. Tiana Lynn Torres, DCNPI 1205113198
Title
Owner
Phone
(847) 265-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038.012071 IL Primary

Addresses

Primary practice location

36735 N. Il 83
Ste D
Lake Villa, IL 60046

Mailing address

36735 N. Il 83
Ste D
Lake Villa, IL 60046
Phone (847) 265-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190508001674 IL Part B Supplier - Clinic/Group Practice 1254673486 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Villa, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1861894081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36735 N. IL 83",
            "address_2": "STE D",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-265-5600",
            "fax_number": "847-245-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36735 N. IL 83",
            "address_2": "STE D",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-265-5600",
            "fax_number": "847-245-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE GOAL WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "TIANA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-265-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Villa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.