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JOLIET HEALTH & REHAB, LLC
Complete NPI Record 1467841569
Chiropractor in Chicago, IL

NPI Status: Active since January 13, 2015

Contact Information

910 W VAN BUREN ST
SUITE 232
CHICAGO, IL
ZIP 60607
Phone: (305) 608-9248

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Second Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider First Line Business Practice Location Address
  12. Provider Second Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Authorized Official Last Name
  21. Authorized Official First Name
  22. Authorized Official Title or Position
  23. Authorized Official Telephone Number
  24. Healthcare Provider Taxonomy Code 1
  25. Provider License Number 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Is Organization Subpart
  29. Authorized Official Credential Text
  30. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1467841569. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1467841569
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The last name of the provider. If the provider is an individual, this is the legal name.
The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 910 W VAN BUREN ST
The middle name of the provider, if the provider is an individual.
Provider Second Line Business Mailing Address: SUITE 232
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Business Mailing Address City Name: CHICAGO
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Mailing Address State Name: IL
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address Postal Code: 606073523
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 910 W VAN BUREN ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SUITE 232
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CHICAGO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: IL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 606073523
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3056089248
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/13/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 1/13/2015
The date that a record was last updated or changed.
Authorized Official Last Name: SUSSMAN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: TODD
The first name of the authorized official.
Authorized Official Title or Position: OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 3056089248
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 111N00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 038.012017
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 1: IL
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Is Organization Subpart: N
Authorized Official Credential Text: DC
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP