Organization Active NPI

Northside Wellness Center LTD

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1982294856
Registry record updated Jan 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NORTHSIDE WELLNESS CENTER LTD
Practice address
7001 W Higgins Ave # 2a
Chicago, IL 60656-1949
Phone
(773) 852-1236
NPI assigned
Jan 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2021

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

Authorized official

Name
Samantha Szyska, DCNPI 1528508629
Title
Doctor
Phone
(773) 852-1236

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

7001 W Higgins Ave # 2a
Chicago, IL 60656-1949

Mailing address

4581 N Merrimac Ave
Chicago, IL 60630-3017
Phone (773) 852-1236

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210407000454 IL Part B Supplier - Clinic/Group Practice 7315354412 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

7001 W Higgins Ave
Ste 2
Chicago, IL 60656

7001 W Higgins Ave
Ste 2A
Chicago, IL 60656
Phone (773) 413-0435

7001 W Higgins Ave
#2A
Chicago, IL 60656
Phone (773) 852-1236

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611446400000",
    "number": "1982294856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4581 N MERRIMAC AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303017",
            "telephone_number": "773-852-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 W HIGGINS AVE # 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561949",
            "telephone_number": "773-852-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE WELLNESS CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-24",
        "last_updated": "2021-01-24",
        "certification_date": "2021-01-24",
        "status": "A",
        "authorized_official_last_name": "SZYSKA",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "773-852-1236",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 24, 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.