Chiro Wellness Center Metro of Hyde Park LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHIRO WELLNESS CENTER METRO OF HYDE PARK LLC

Practice address

1644 E 53Rd St
Suite a
Chicago, IL 60615-4210

Phone

(773) 332-1123

Fax

(773) 332-1126

NPI assigned

Dec 2, 2010

Last updated

Oct 24, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sam WangNPI 1073520136

Title

Coo

Phone

(630) 468-1824

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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.

• Thomas Macneill-Zimmerman, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1255423372
  Medicare reassignment NPD
• Sam Wang, DC

  • Chiropractor
  • Libertyville, IL
  • NPI 1073520136
  Authorized official Same address or phone
• Bridget Monaghan, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1922300763
  NPD (past)
• Brian Rutecki, DC

  • Chiropractor
  • Oak Brook, IL
  • NPI 1104841782
  NPD (past)

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1912209586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 E 53RD ST",
            "address_2": "SUITE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154210",
            "telephone_number": "773-332-1123",
            "fax_number": "773-332-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO WELLNESS CENTER METRO OF HYDE PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-468-1824"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiro One Wellness Center Metro of West Loop LLC
• Chiro One Wellness Center of East Hyde Park LLC
• Chiro One Wellness Center of Evergreen Park LLC
• Chiro One Wellness Center of North Orleans PLLC
• Chiro One Wellness Center of the Gold Coast LLC
• Chiro360 PLLC
• Chiro4Health, PC
• Chirochicago Chiropractic & Sports Injury Center, LTD.
• Chiron Behavioral Health PLLC
• Chiron Wellness PLLC

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.