NPIMap

Organization Active NPI

Kelly Chiropractic and Wellness Center S.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1871736801
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.007892 Issued in IL
Legal business name
KELLY CHIROPRACTIC AND WELLNESS CENTER S.C.
Practice address
1018 N California Ave
Chicago, IL 60622-3408
Phone
(773) 772-0007
NPI assigned
Apr 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Authorized official

Name
Dr. Sean BushnellNPI 1184754491
Title
Clinic Director
Phone
(773) 772-0007

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 038.007892 IL Primary

Addresses

Primary practice location

1018 N California Ave
Chicago, IL 60622-3408

Mailing address

1018 N California Ave
Chicago, IL 60622-3408

National Provider Directory

National Provider Directory

Locations

1018 N California Ave
Chicago, IL 60622
Phone (773) 772-0007

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1871736801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223408",
            "telephone_number": "773-772-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CHIROPRACTIC AND WELLNESS CENTER S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "BUSHNELL",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "773-772-0007",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.007892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 7, 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.