NORTHSIDE CHIROPRACTIC CLINIC LTD NPI 1689017097

NPI Information

  • NPI: 1689017097
  • Provider Name: NORTHSIDE CHIROPRACTIC CLINIC LTD
  • Classification: Chiropractor - 111NI0013X
  • Specialization: Independent Medical Examiner
  • Entity Type: Organization
  • CLIA Number: 24D0907481
  • Address: 3107 PENN AVE N
    MINNEAPOLIS, MN
    ZIP 55411
  • Phone: (612) 522-0440

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NPI Details

NORTHSIDE CHIROPRACTIC CLINIC LTD is an independent medical examiner chiropractor in Minneapolis, MN. The provider is a chiropractor and special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practitioners to clarify clinical, disability, liability or other case issues. NORTHSIDE CHIROPRACTIC CLINIC LTD NPI is 1689017097. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3107 PENN AVE N
MINNEAPOLIS, MN
ZIP 55411-123
Phone: (612) 522-0440
Fax: (612) 522-1816

The provider's authorized official is Greg T Olson .
The authorized official title is President/ceo and has the following contact phone number (612) 522-0440.

The CLIA number assigned to this NPI record is 24D0907481 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/16/2013 and was last updated on 7/10/2013.

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 License Number License State Primary
1111NI0013XChiropractorIndependent Medical Examiner2197MINNESOTAYes

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
1890828100MEDICAIDMINNESOTA

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: 3/30/2025

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