NPIMap

Organization Active NPI

Bearded Chiro Inc.

Doing business as BrightLife Lombard

  • Chiropractor
  • Lombard, IL
National Provider Identifier
1871224642
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BEARDED CHIRO INC.
Doing business as
BrightLife Lombard
Practice address
442 E Roosevelt Rd
Lombard, IL 60148-4630
Phone
(630) 261-0001
Fax
(331) 200-3123
NPI assigned
Jun 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Authorized official

Name
Dr. James Sronkoski, DCNPI 1528565017
Title
Owner
Phone
(630) 261-0001

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 Primary

Addresses

Primary practice location

442 E Roosevelt Rd
Lombard, IL 60148-4630

Mailing address

442 E Roosevelt Rd
Lombard, IL 60148-4630
Phone (630) 261-0001

Other names 1

  • BrightLife Lombard Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220805000548 IL Part B Supplier - Clinic/Group Practice 7315329455 Receives reassigned benefits from 2 practitioners
Practice locations: Lombard, 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.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1871224642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 E ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484630",
            "telephone_number": "630-261-0001",
            "fax_number": "331-200-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 E ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484630",
            "telephone_number": "630-261-0001",
            "fax_number": "331-200-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEARDED CHIRO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "SRONKOSKI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-261-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BrightLife Lombard",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.