Chiro One Wellness Center of Burr Ridge LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038010467 Issued in IL

Legal business name

CHIRO ONE WELLNESS CENTER OF BURR RIDGE LLC

Practice address

316 Burr Ridge Parkway
Burr Ridge, IL 60527

Phone

(630) 655-9970

Fax

(630) 655-9870

NPI assigned

Jun 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sam Wang, DCNPI 1073520136

Title

Coo

Phone

(630) 468-1824

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Chirag Shah, DC

  • Chiropractor
  • Burr Ridge, IL
  • NPI 1992749881
  Medicare reassignment NPD
• Sam Wang, DC

  • Chiropractor
  • Libertyville, IL
  • NPI 1073520136
  NPD (past) Authorized official
• Anthony Abdul Deneal

  • Chiropractor
  • Oak Brook, IL
  • NPI 1457384372
  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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1912935982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "SUITE 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": "316 BURR RIDGE PARKWAY",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-655-9970",
            "fax_number": "630-655-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF BURR RIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "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",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01633281",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Chejn
• Ewa Chelmicka Schorr, MD
• Susy K Cherian, DNP,MSN, RN, FNP-BC
• Melissa A Chew, PHARM.D
• Chicago Clinical Research Institute Inc.
• Selina Lai-Ming Chow, MD
• Ashish K Chugh
• Kishore A Chugh, R.PH
• Katherine Ciannella, OTD, OTR/L
• Erika Claud, MD

• Chiropractor in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.