Chiro One Wellness Center of Evanston SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHIRO ONE WELLNESS CENTER OF EVANSTON SC

Practice address

1954 Dempster St
Evanston, IL 60202-1016

Phone

(847) 475-4545

NPI assigned

Jun 10, 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, D.C.

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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Coriann Bauer, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1669413647
  Medicare reassignment NPD
• Maia Sharashidze, DC

  • Chiropractor
  • Arlington Heights, IL
  • NPI 1568114940
  Medicare reassignment NPD
• Stuart Bernsen, D.C.

  • Chiropractor
  • Evanston, IL
  • NPI 1386691566
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519862400000",
    "number": "1932140647",
    "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",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 DEMPSTER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021016",
            "telephone_number": "847-475-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF EVANSTON SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2018-03-01",
        "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": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1635132",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Children's Wellness Services, PLLC
• Childrens Memorial Hospital
• Henry Chill
• Delaney Glenn Chimienti, LCPC
• Celina Chiodo
• Chiropractic Health Management, LLC
• James CHI-Hsien Chiu, M.D.
• Lily L. Cho-Mui, MD
• Anne Chodzko, PHD
• Victoria Choe

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.