Organization Active NPI

Chiro One Wellness Center of Hales Corners, LLC

  • Chiropractor
  • Hales Corners, WI
National Provider Identifier
1881127900
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4407-12 Issued in WI
Legal business name
CHIRO ONE WELLNESS CENTER OF HALES CORNERS, LLC
Practice address
5305 S 108TH St
Hales Corners, WI 53130-1332
Phone
(414) 491-0096
NPI assigned
Apr 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Chris Roeh
Title
Evp, Cfo
Phone
(630) 468-1824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4407-12 WI Primary

Addresses

Primary practice location

5305 S 108TH St
Hales Corners, WI 53130-1332

Mailing address

814 Commerce Dr Ste 300
Oak Brook, IL 60523-8823
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171215001030 WI Part B Supplier - Clinic/Group Practice 7719245984 Receives reassigned benefits from 1 practitioner
Practice locations: Hales Corners, WI

National Provider Directory

National Provider Directory

Locations

5305 S 108th St
Hales Corners, WI 53130
Phone (414) 235-9708

Practitioners & affiliated clinicians

Practitioners 1

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": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1881127900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 COMMERCE DR STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238823",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301332",
            "telephone_number": "414-491-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF HALES CORNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "ROEH",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "EVP, CFO",
        "authorized_official_telephone_number": "630-468-1824"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4407-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.