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ILLINOIS SPINAL & SPORTS REHABILITATION SC NPI 1275651242


NPI Information

NPI: 1275651242
Provider Name: ILLINOIS SPINAL & SPORTS REHABILITATION SC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
4015 PLAINFIELD NAPERVILLE RD
SUITE 105
NAPERVILLE, IL
ZIP 60564
Phone: (630) 904-9700
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ILLINOIS SPINAL & SPORTS REHABILITATION SC is a chiropractor in Naperville, IL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. ILLINOIS SPINAL & SPORTS REHABILITATION SC NPI is 1275651242. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4015 PLAINFIELD NAPERVILLE RD
SUITE 105
NAPERVILLE, IL
ZIP 60564-136
Phone: (630) 904-9700
Fax: (630) 904-9713

The provider's authorized official is Eric J Lukosus .
The authorized official title is Business Owner and has the following contact phone number (630) 904-9700.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 3/1/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1225100000XPhysical Therapist70015459ILLINOISNo
2111N00000XChiropractor038008240INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17553267OTHERILLINOISAETNA ID
21992774277OTHERILLINOISINDIVIDUAL NPI
39932170OTHERILLINOISBLUE CROSS BLUE SHIELD
4209997MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
51427196583OTHERILLINOISINDIVIDUAL NPI
6U84782MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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