Organization Active NPI

Chiro One Wellness Center of Orland Hills Clinic, LLC

  • Chiropractor
  • Orland Hills, IL
National Provider Identifier
1972690139
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER OF ORLAND HILLS CLINIC, LLC
Practice address
9121 159TH St
Suite J-K
Orland Hills, IL 60487-5901
Phone
(708) 675-1400
Fax
(708) 675-1405
NPI assigned
Oct 9, 2006
Last updated
Dec 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Authorized official

Name
Dr. Sam Wang, D.C.NPI 1073520136
Title
Coo
Phone
(630) 468-1824

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

9121 159TH St
Suite J-K
Orland Hills, IL 60487-5901

Mailing address

2625 Butterfield Rd
Suite 301N
Oak Brook, IL 60523-1234
Phone (630) 468-1824

Other identifiers 1

IdentifierTypeStateIssuer
1636647OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061220000266 IL Part B Supplier - Clinic/Group Practice 6406855436 Receives reassigned benefits from 2 practitioners
Practice locations: Orland Hills, IL

National Provider Directory

National Provider Directory

Locations

9121 159th St
Ste A
Orland Hills, IL 60487
Phone (630) 771-0438

9121 159th St
Ste Jk
Orland Hills, IL 60487
Phone (708) 675-1400

9121 159th St
Unit Jk
Orland Hills, IL 60487
Phone (630) 771-0438

Practitioners & affiliated clinicians

Practitioners 6

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": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1972690139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "SUITE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9121 159TH ST",
            "address_2": "SUITE J-K",
            "city": "ORLAND HILLS",
            "state": "IL",
            "postal_code": "604875901",
            "telephone_number": "708-675-1400",
            "fax_number": "708-675-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF ORLAND HILLS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2017-12-27",
        "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": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1636647",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.