- Practice location
- 560 W Diversey Pkwy, Chicago, IL 60614
- Phone
- 773-524-6830
- Fax
- —
- Last updated
- October 2, 2013
Active Wellness LLC is a healthcare organization based in Chicago, IL. The NPI number for Active Wellness LLC is 1891120408. The current practice location address is 560 W Diversey Pkwy, Chicago, IL 60614 and the office can be reached by phone at 773-524-6830. The NPI was assigned on September 13, 2013 and the record was last updated in NPPES on October 2, 2013.
●Provider Profile Details
- NPI Number
- 1891120408
- Provider Name
- Active Wellness LLC
- Entity Type
- Organization (Type 2 NPI)
- Primary Taxonomy
- Chiropractor · 111N00000X
- Organization Subpart
- No
- Authorized Official
- Andrew Ingley · Manager · 813-220-9113
- Enumeration Date
- September 13, 2013
- Last Update Date
- October 2, 2013
- NPI Status
- Active
◉Business Practice Location Address
- Address
- 560 W Diversey Pkwy
Chicago, IL 60614 - City
- Chicago
- State
- Illinois
- ZIP
- 60614
- Country
- US
- Phone Number
- 773-524-6830
✉Business Mailing Address
- Address
- 4555 N Lincoln Ave
Chicago, IL 60625-2102 - City
- Chicago
- State
- IL
- ZIP
- 60625-2102
- Phone Number
- 773-328-8153
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Chiropractor, Nutrition 193200000X - Multi-Specialty Group | 111NN1001X | No | — | — |
| Chiropractor, Pediatric Chiropractor 193200000X - Multi-Specialty Group | 111NP0017X | No | — | — |
| Chiropractor, Sports Physician 193200000X - Multi-Specialty Group | 111NS0005X | No | — | — |
| Acupuncturist 193200000X - Multi-Specialty Group | 171100000X | No | — | — |
| Chiropractor 193200000X - Multi-Specialty Group | 111N00000X | Yes | — | — |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
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View all providers in Chicago →?Frequently Asked Questions
What is the NPI number of Active Wellness LLC?
The NPI number of Active Wellness LLC is 1891120408. It was assigned on September 13, 2013 and is currently active in the NPPES registry.
What is the specialty of Active Wellness LLC?
Active Wellness LLC is registered under the primary taxonomy Chiropractor (code 111N00000X).
Where does Active Wellness LLC practice?
The practice location is 560 W Diversey Pkwy, Chicago, IL 60614. The office can be reached at 773-524-6830 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1891120408 directly on the NPPES registry website at npiregistry.cms.hhs.gov.