ENVISION HEALTH CLINIC (NPI# 1184079782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184079782 |
Entity Type | Organization |
Organization Name | ENVISION HEALTH CLINIC |
Practice Address |
840 S Waukegan Rd #201 Lake Forest IL 60045-2608 |
Practice Telephone | 2245445033 |
Enumeration Date | 2016-05-02 |
Last Update Date | 2016-05-02 |
Authorized Official Name | KIMBERLY C FLETCHER (OWNER) |
Authorized Official Telephone | 2245445033 |
Authorized Official Credential | DC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 111N00000X | Chiropractor | 038011833 | IL | Chiropractic Providers |
Y | 111N00000X | Chiropractor | 038012962 | IL | Chiropractic Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION | 038012962 | 01 |
IL | ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION | 038011833 | 01 |
Street Address |
840 S WAUKEGAN RD #201 |
City | LAKE FOREST |
State | IL |
Zip Code | 60045-2608 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194724542 | Unique Medical Imaging Sc | Radiology | 840 S Waukegan Rd, Suite 214, Lake Forest, IL 60045-2608 | 2005-07-19 |
1144882259 | Alyssa Pearlstein | Social Worker | 840 S Waukegan Rd, Lake Forest, IL 60045-2608 | 2019-06-28 |
1609228683 | Kurt J Brotherson | Family Medicine | 840 S Waukegan Rd, 203, Lake Forest, IL 60045-2608 | 2016-07-01 |
1952790701 | Dennis Rogan | Hearing Instrument Specialist | 840 S Waukegan Rd, Lake Forest, IL 60045-2608 | 2015-01-16 |
1457658304 | Kimberly Conn Fletcher | Chiropractor | 840 S Waukegan Rd, Suite 201, Lake Forest, IL 60045-2608 | 2011-02-11 |
1790938561 | Carrie Podolsky | Social Worker | 840 S Waukegan Rd, Lake Forest, IL 60045-2608 | 2008-10-24 |
1356501365 | Derek James Bock | Dentist | 840 S Waukegan Rd, Suite 107, Lake Forest, IL 60045-2608 | 2008-06-12 |
1073730131 | Anokhi Dalia Bock | Dentist | 840 S Waukegan Rd, Suite 107, Lake Forest, IL 60045-2608 | 2007-04-19 |
1508867441 | Deepak P Dalia | Radiology | 840 S Waukegan Rd, Suite 214, Lake Forest, IL 60045-2608 | 2005-08-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851931109 | Spine & Wellness Clinic, Inc. | Chiropractor | 775 N Bank Lane Suite 101, Lake Forest, IL 60045 | 2020-01-14 |
1184278640 | Mary Belluomini Dipietro | Dietitian, Registered | 1000 North Westmoreland Rd., Lake Forest, IL 60045 | 2019-08-01 |
1336621747 | Brook Elizabeth Orvis | Physical Therapist | 1000 N Westmoreland Road, 2nd Floor, Pavilion B, Lake Forest, IL 60045 | 2018-08-31 |
1336621028 | Michelle Nebel | Audiologist | 225 East Deerpath, Suite 223, Lake Forest, IL 60045 | 2018-08-30 |
1467951731 | Devan Keesling | Audiologist | 800 N Westmoreland Rd Ste Ll30, Lake Forest, IL 60045 | 2018-02-01 |
1023516796 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1000 N Westmoreland Rd Ste A, Lake Forest, IL 60045 | 2018-01-29 |
1275056780 | Karen Elizabeth Cohen | Counselor | 1331 S. Estate Lane, Lake Forest, IL 60045 | 2017-07-18 |
1497281711 | Caroline Connors | Speech-Language Pathologist | 660 Westmoreland Road, Lake Forest, IL 60045 | 2017-05-05 |
1013453406 | Katie L Konopacz | Nurse Practitioner | 1000 N Westmoreland Rd # B, Lake Forest, IL 60045 | 2017-01-10 |
1225424575 | Sean Robert Wessel | Internal Medicine | 1000 N Westmoreland Rd Ste 3556, Lake Forest, IL 60045 | 2015-04-14 |
Find all providers in zip 60045 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
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. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407462062 | Glass Chiropractic Corporation | Chiropractor | 22672 Lambert St Ste 601, Lake Forest, CA 92630-1613 | 2020-09-18 |
1962036616 | Lane N Tran | Chiropractor | 26242 Dimension Dr Ste 150, Lake Forest, CA 92630-7811 | 2020-03-02 |
1851931109 | Spine & Wellness Clinic, Inc. | Chiropractor | 775 N Bank Lane Suite 101, Lake Forest, IL 60045 | 2020-01-14 |
1467942573 | Nicholas Deliberato | Chiropractor | 22706 Aspan St Ste 702, Lake Forest, CA 92630-1641 | 2018-05-14 |
1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
1831583236 | Farangis Sabeti-kolahi Chiropractic, Inc. | Chiropractor | 22762 Aspen St Ste 205, Lake Forest, CA 92630-1604 | 2015-03-24 |
1437440047 | Kari Leigh Young | Chiropractor | 23101 Lake Center Dr Ste 110, Lake Forest, CA 92630-2882 | 2011-04-29 |
1154629699 | Straw Chiropractic Corp | Chiropractor | 23101 Lake Center Dr Ste 101, Lake Forest, CA 92630-2898 | 2011-03-08 |
1720385065 | Chi Therapy Center | Chiropractor | 24531 Trabuco Rd Ste C&d, Lake Forest, CA 92630-2162 | 2011-02-23 |
1265739718 | Christian Chee Chiropractic Inc | Chiropractor | 20671 Lake Forest Dr, Ste B-102, Lake Forest, CA 92630-7746 | 2011-02-18 |
Find all providers in LAKE FOREST |
City | LAKE FOREST |
Zip Code | 60045 |
Please comment or provide details below to improve the information on ENVISION HEALTH CLINIC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.