Individual provider Active NPI

Emmy Xiaotian Wang, DC

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1922246974
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011299 Issued in IL
Practice address
2456 Fawn Lake Cir
Naperville, IL 60564-4619
Phone
(630) 542-2598
Fax
(630) 470-9387
NPI assigned
Jan 29, 2009
Last updated
Apr 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011299 IL Primary

Addresses

Primary practice location

2456 Fawn Lake Cir
Naperville, IL 60564-4619

Mailing address

2456 Fawn Lake Cir
Naperville, IL 60564-4619
Phone (630) 542-2598

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091007000106 IL Practitioner - Chiropractic 5991841884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Advanced Wellness Medical LLCGroup PAC ID 6800113887, 3 clinicians

Practice addresses (Care Compare)

6325 Main St
Suite 120
Woodridge, IL 60517-1291

6325 Main St
Suite 120
Woodridge, IL 60517-1299
Phone (630) 541-6773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011299ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wellness Center, LTD Chiropractor CurrentSince Jun 26, 2015 Accepting new patients
Advanced Wellness Medical, LLC CurrentSince Dec 29, 2014 Accepting new patients
Advanced Wellness of Naperville, LLC Chiropractor PastSince Jun 19, 2014 Accepting new patients
Chiro One Wellness Center of Glenview Clinic, LLC Chiropractor PastSince May 28, 2017 Accepting new patients
Chiro One Wellness Center of Naperville LLC Chiropractor Past Accepting new patients

Locations

6325 Main St
Ste 120
Woodridge, IL 60517
Phone (630) 541-6773

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1922246974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 FAWN LAKE CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644619",
            "telephone_number": "630-542-2598",
            "fax_number": "630-470-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 FAWN LAKE CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644619",
            "telephone_number": "630-542-2598",
            "fax_number": "630-470-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "EMMY",
        "middle_name": "XIAOTIAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.