NPIMap

Organization Active NPI

Olson Chiropractic, Inc.

  • Chiropractor
  • Aurora, IL
National Provider Identifier
1932292992
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008765 Issued in IL
Legal business name
OLSON CHIROPRACTIC, INC.
Practice address
2116 W Galena Blvd
Suite 112
Aurora, IL 60506-3533
Phone
(630) 897-1895
Fax
(630) 897-2043
NPI assigned
Oct 2, 2006
Last updated
Feb 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Authorized official

Name
Dr. Kenneth J Olson, DCNPI 1417044363
Title
Owner
Phone
(630) 897-1895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 038008765 IL Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 038-012547 IL
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 038011191 IL

Addresses

Primary practice location

2116 W Galena Blvd
Suite 112
Aurora, IL 60506-3533

Mailing address

2124 W Galena Blvd
Suite 104
Aurora, IL 60506
Phone (630) 897-1895

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070103000394 IL Part B Supplier - Clinic/Group Practice 9537169263 Receives reassigned benefits from 2 practitioners
Practice locations: Aurora, IL

National Provider Directory

National Provider Directory

Locations

2116 W Galena Blvd
Ste 112
Aurora, IL 60506
Phone (630) 897-1895

2124 W Galena Blvd
Ste 104
Aurora, IL 60506
Phone (630) 897-1895

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1932292992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 W GALENA BLVD",
            "address_2": "SUITE 104",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60506",
            "telephone_number": "630-897-1895",
            "fax_number": "630-897-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 W GALENA BLVD",
            "address_2": "SUITE 112",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063533",
            "telephone_number": "630-897-1895",
            "fax_number": "630-897-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLSON CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-897-1895",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008765",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-012547",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011191",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.