AXIAL SPINE & WELLNESS, LLC (NPI# 1932654084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932654084 |
| Entity Type | Organization |
| Organization Name | AXIAL SPINE & WELLNESS, LLC |
| Practice Address |
954 W Washington Blvd Suite 110 Chicago IL 60607-2224 |
| Mailing Address |
954 W Washington Blvd Ste 610 Chicago IL 60607-2293 |
| Practice Telephone | 3082279071 |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2020-09-28 |
| Authorized Official Name | TODD PETERSON (OWNER) |
| Authorized Official Telephone | 3125234392 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038012711 | IL | Chiropractic Providers |
| Street Address |
954 W WASHINGTON BLVD SUITE 110 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60607-2224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568430205 | Methodist Youth Services, Inc. | Public Health or Welfare | 954 W Washington Blvd, Chicago, IL 60607-2224 | 2006-03-09 |
| 1942695226 | Antoinette M Dezzutti Lcsw PC | Social Worker | 954 W Washington Blvd, Ste 402 Box 14, Chicago, IL 60607-2224 | 2015-04-02 |
| 1679914550 | Bonnie Kilfoyle | Psychologist | 954 W Washington Blvd, 3rd Floor, Chicago, IL 60607-2224 | 2013-07-08 |
| 1811228174 | Terri Richmond | Psychologist | 954 W Washington Blvd, Suite 720, Chicago, IL 60607-2224 | 2010-01-26 |
| 1447323365 | Ana F. Linares | Psychologist | 954 W Washington Blvd, Suite 720, Chicago, IL 60607-2224 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992349237 | Portia Dowd | Registered Nurse | 140 N Ashland, Chicago, IL 60607 | 2019-10-30 |
| 1114577210 | Joseph Matthew Thiel | Emergency Medical Technician, Intermediate | 558 West De Koven, Chicago, IL 60607 | 2019-09-19 |
| 1215585757 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1034 West Lake St, Chicago, IL 60607 | 2019-08-28 |
| 1003462821 | Michael Marek Maka | Psychologist | 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 | 2019-08-16 |
| 1558922344 | Kellie Meyer | Speech-Language Pathologist | Eyas Landing West Loop, 1409 W. Carroll Ave, Chicago, IL 60607 | 2019-06-24 |
| 1811460108 | Corinna House | Social Worker | 932 W Washington, Chicago, IL 60607 | 2019-01-09 |
| 1962979518 | Louise Taussig Bush | Counselor | 1142 West Madison Street, Suite 406, Chicago, IL 60607 | 2018-10-31 |
| 1568941318 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1051 W Randolph, Chicago, IL 60607 | 2018-08-13 |
| 1851883425 | Alefiyah Zulfiqar Pishori | Psychologist | 1200 West Harrison St, Chicago, IL 60607 | 2018-05-30 |
| 1679062954 | Elizabeth R Rolston | Physical Therapist | 24 S Morgan St Ste 100, Chicago, IL 60607 | 2018-05-02 |
| Find all providers in zip 60607 | ||||
| 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.