Individual provider Active NPI

Shaquala Reese, D.C.

  • Chiropractor
  • Bolingbrook, IL
National Provider Identifier
1962844860
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012396 Issued in IL
Practice address
486 W Boughton Rd # A1-A3
Bolingbrook, IL 60440-2399
Phone
(630) 864-6486
Fax
(331) 757-5902
NPI assigned
Jul 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012396 IL Primary

Addresses

Primary practice location

486 W Boughton Rd # A1-A3
Bolingbrook, IL 60440-2399

Mailing address

486 W Boughton Rd # A1-A3
Bolingbrook, IL 60440-2399
Phone (630) 864-6486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170120000384 IL Practitioner - Chiropractic 5991087140 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

246 E Janata Blvd
Suite 210
Lombard, IL 60148-5378
Phone (630) 949-8808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012396ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Igh Wellness Inc Chiropractor CurrentSince Aug 1, 2025 Accepting new patients
Thrive Life Wellness Center Inc PastSince Dec 18, 2013 Accepting new patients

Locations

486 W Boughton Rd
#A1A3
Bolingbrook, IL 60440
Phone (630) 864-6486

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1962844860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 W BOUGHTON RD # A1-A3",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402399",
            "telephone_number": "630-864-6486",
            "fax_number": "331-757-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 W BOUGHTON RD # A1-A3",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402399",
            "telephone_number": "630-864-6486",
            "fax_number": "331-757-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "SHAQUALA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.