Optimum Health Chiropractic & Wellness Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-009778 Issued in IL

Legal business name

OPTIMUM HEALTH CHIROPRACTIC & WELLNESS CENTER, INC.

Practice address

841 E 162ND St
South Holland, IL 60473-2465

Phone

(708) 331-9881

Fax

(708) 331-9876

NPI assigned

Mar 17, 2006

Last updated

Jan 13, 2010By 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

Ms. Rosemary Chavis, D.C.

Title

Chiropractor Owner

Phone

(708) 331-9881

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1942269139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1665",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604097665",
            "telephone_number": "708-331-9881",
            "fax_number": "708-331-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 E 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732465",
            "telephone_number": "708-331-9881",
            "fax_number": "708-331-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTH CHIROPRACTIC & WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "CHAVIS",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "CHIROPRACTOR OWNER",
        "authorized_official_telephone_number": "708-331-9881",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009778",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "205967",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "01633148",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00091070",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in South Holland, IL
• Providers in South Holland, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.