ACTIVE WELLNESS LLC (NPI# 1891120408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891120408 |
| Entity Type | Organization |
| Organization Name | ACTIVE WELLNESS LLC |
| Practice Address |
560 W Diversey Pkwy Chicago IL 60614 |
| Mailing Address |
4555 N Lincoln Ave Chicago IL 60625-2102 |
| Practice Telephone | 7735246830 |
| Mailing Telephone | 7733288153 |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-10-02 |
| Authorized Official Name | ANDREW INGLEY (MANAGER) |
| Authorized Official Telephone | 8132209113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NN1001X |
Chiropractor Specialization: Nutrition |
Chiropractic Providers | ||
| N | 111NP0017X |
Chiropractor Specialization: Pediatric Chiropractor |
Chiropractic Providers | ||
| N | 111NS0005X |
Chiropractor Specialization: Sports Physician |
Chiropractic Providers | ||
| N | 171100000X | Acupuncturist | Other Service Providers | ||
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151595 | Active Wellness LLC | Occupational Therapist | 120 Sw 4th St Ste 170, Corvallis, OR 97333-4896 | 2019-08-27 |
| 1447685052 | Active Wellness LLC | Chiropractor | 338 E Ohio, Chicago, IL 60611 | 2013-09-13 |
| 1114544970 | Active Wellness LLC | 600 California St Fl 11, San Francisco, CA 94108-2727 | 2020-06-28 | |
| 1427483791 | Active Wellness LLC | Chiropractor | 3514 N Southport Ave, Chicago, IL 60657-1436 | 2013-09-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ACTIVE WELLNESS LLC | 120 Sw 4th St Ste 170, Corvallis, OR 97333 |
| Colorado Business Entities | Active Wellness LLC | 7683 S Gartner Road, Evergreen, CO 80439 |
| Street Address |
560 W DIVERSEY PKWY |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861961690 | David Jon Lewandowski | Chiropractor | 560 W Diversey Pkwy, Chicago, IL 60614-1678 | 2018-11-22 |
| 1891280566 | Lauren Lynn Chaves | Dietitian, Registered | 560 W Diversey Pkwy, Chicago, IL 60614-1678 | 2018-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| 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 |
|---|---|---|---|---|
| 1881208080 | Christian James Koch | Chiropractor | 5100 N Ravenswood Ave Ste 107, Chicago, IL 60640-1710 | 2020-09-04 |
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1104448547 | Katie Niebur | Chiropractor | 6909 W Medill Ave, Chicago, IL 60707-2910 | 2020-05-07 |
| 1063031003 | Bazan's Health Center Inc | Chiropractor | 4012 W 63rd St, Chicago, IL 60629-4606 | 2020-04-09 |
| 1346875861 | Christopher A Haslett Dc P.c | Chiropractor | 400 N Wells St Ste 300, Chicago, IL 60654-2761 | 2020-03-04 |
| 1245870138 | Be Well Chiropractic Clinics LLC | Chiropractor | 3648 W Montrose Ave Apt 2e, Chicago, IL 60618-1979 | 2020-01-08 |
| 1982242186 | Michael Tal Risher | Chiropractor | 2378 N Elston Ct, Chicago, IL 60614-2929 | 2019-12-18 |
| 1821632423 | Rachel Nicole Leibovitz | Chiropractor | 624 W Belmont Ave, Chicago, IL 60657-4511 | 2019-11-06 |
| 1053954180 | Aaron Alexander Bryant | Chiropractor | 125 N Halsted St Ste 202, Chicago, IL 60661-2160 | 2019-10-22 |
| 1073156238 | Omar A. Bleibel | Chiropractor | 4801 W Peterson Ave Ste 505, Chicago, IL 60646-5795 | 2019-10-21 |
| Find all providers in CHICAGO | ||||
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| 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.