ACTIVE WELLNESS, LLC (NPI# 1902162662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902162662 |
| Entity Type | Organization |
| Organization Name | ACTIVE WELLNESS, LLC |
| Practice Address |
4555 N Lincoln Ave Chicago IL 60625-2102 |
| Practice Telephone | 7733288153 |
| Mailing Telephone | 7733288153 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2014-02-14 |
| Authorized Official Name | ANDREW INGLEY (GENERAL MANAGER) |
| Authorized Official Telephone | 8132209113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NN1001X |
Chiropractor Specialization: Nutrition |
24800594 | IL | Chiropractic Providers |
| N | 111NP0017X |
Chiropractor Specialization: Pediatric Chiropractor |
24800594 | IL | Chiropractic Providers |
| N | 171100000X | Acupuncturist | Other Service Providers | ||
| Y | 111N00000X | Chiropractor | 24800594 | IL | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265847545 | Active Wellness, LLC | Chiropractor | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2014-06-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ACTIVE WELLNESS, LLC | 120 N Second St, Ashland, OR 97520 |
| Connecticut Business Registrations | ACTIVE WELLNESS, LLC | 1204 Whitney Ave, Suite 312, Hamden, CT 06517 |
| Street Address |
4555 N LINCOLN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60625-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841818762 | Jessica Lauren Pierce | Chiropractor | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2020-07-07 |
| 1912489683 | Seanna M Tully | Acupuncturist | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2018-08-30 |
| 1598250763 | Parisa Samsami | Chiropractor | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2018-06-28 |
| 1437668415 | Joan Osborn | Acupuncturist | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2017-09-22 |
| 1093170276 | Kelly Kirles | Acupuncturist | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2015-12-15 |
| 1700254844 | Olivia Wagner | Dietitian, Registered | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2015-09-07 |
| 1265847545 | Active Wellness, LLC | Chiropractor | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2014-06-25 |
| 1891125613 | Alaina Gemelas | Chiropractor | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2013-11-14 |
| 1760824676 | Jessica Rachael Hehmeyer | Chiropractor | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2013-07-19 |
| 1194074955 | Katelyn Giancola | Chiropractor | 4555 N Lincoln Ave, Chicago, IL 60625-2102 | 2012-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726615 | B Wise Rehabilitation Pllc | Physical Therapist | 4754 N Lincoln Ave, Fl 1, Chicago, IL 60625 | 2020-10-07 |
| 1700490448 | Anita Saini | Pharmacist | 5140 N California Ave, Chicago, Il 60625, Chicago, IL 60625 | 2020-09-01 |
| 1699303164 | Marina Karamanis | Student in an Organized Health Care Education/Training Program | Swedish Hospital, 5140 N. California Ave, Chicago, IL 60625 | 2020-03-31 |
| 1063050227 | Jacqueline Guadalupe Saldana | Behavioral Analyst | 8616 W Catalpa Ave, Suite 1106, Chicago, IL 60625 | 2019-12-18 |
| 1912557802 | Six Senses Therapy LLC | Social Worker | 2334 W. Lawrence Avenue, Suite 204c, Chicago, IL 60625 | 2019-09-13 |
| 1982266110 | Noreen Randhawa | Family Medicine | Swedish Hospital Part of North Shore, 5145 N. California Ave., Chicago, IL 60625 | 2019-07-09 |
| 1376102202 | Nita Gupta | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Department, 5145 N. California Ave, Chicago, IL 60625 | 2019-06-13 |
| 1841763471 | Alexandra Taskier | Counselor | 5359 N Bowmanville Ave., Chicago, IL 60625 | 2019-01-07 |
| 1013490143 | Paula Bielnicka | Pharmacist | Swedish Covenant Hospital - Pharmacy, 5140 N California Ave, Chicago, IL 60625 | 2018-09-14 |
| 1902397078 | Rebecca Abraham | Hospitalist | 5145 N California Ave Ofc M331, Chicago, IL 60625 | 2018-05-24 |
| Find all providers in zip 60625 | ||||
| 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.