ACTIVE WELLNESS LLC NPI 1427483791

NPI Information

NPI: 1427483791
Provider Name: ACTIVE WELLNESS LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
3514 N SOUTHPORT AVE
CHICAGO, IL
ZIP 60657
Phone: (773) 598-4387
Get Directions

ACTIVE WELLNESS LLC is a chiropractor in Chicago, 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. ACTIVE WELLNESS LLC NPI is 1427483791. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3514 N SOUTHPORT AVE
CHICAGO, IL
ZIP 60657-436
Phone: (773) 598-4387

The provider's authorized official is Andrew Ingley .
The authorized official title is Manager and has the following contact phone number (813) 220-9113.

The enumeration date for this NPI number is 9/5/2013 and was last updated on 9/5/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	111NN1001X	Chiropractor	Nutrition	No
2	111NP0017X	Chiropractor	Pediatric Chiropractor	No
3	111NS0005X	Chiropractor	Sports Physician	No
4	171100000X	Acupuncturist		No
5	111N00000X	Chiropractor		Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IL8494	MEDICARE PIN	ILLINOIS

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

NPI Synchronization or Removal

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