Organization Active NPI

Marshall Family Wellness LLC

Doing business as Chicago Spine and Joint Care

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1962125864
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MARSHALL FAMILY WELLNESS LLC
Doing business as
Chicago Spine and Joint Care
Practice address
111 W Jackson Blvd Ste 1160
Chicago, IL 60604-3896
Phone
(312) 583-0061
Fax
(312) 583-0061
NPI assigned
Sep 26, 2022
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Mikel Marshall, DCNPI 1407454424
Title
President
Phone
(312) 583-0061

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
Chiropractor 111N00000X NU Primary
Acupuncturist 171100000X NU
Rehabilitation Chiropractor 111NR0400X NU

Addresses

Primary practice location

111 W Jackson Blvd Ste 1160
Chicago, IL 60604-3896

Mailing address

111 W Jackson Blvd Ste 1160
Chicago, IL 60604-3896
Phone (312) 583-0061

Other names 1

  • Chicago Spine and Joint Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230919003220 IL Part B Supplier - Clinic/Group Practice 3274997598 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

111 W Jackson Blvd
Ste 1160
Chicago, IL 60604
Phone (312) 583-0061

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1962125864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD STE 1160",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043896",
            "telephone_number": "312-583-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD STE 1160",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043896",
            "telephone_number": "312-583-0061",
            "fax_number": "312-583-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL FAMILY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "MIKEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-583-0061",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Spine and Joint Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.