DR. SAM WANG (NPI# 1073520136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073520136 |
| Entity Type | Individual |
| Full Name | DR. SAM WANG |
| Credential | DC |
| Practice Address |
149 Buckley Rd Libertyville IL 60048-1400 |
| Mailing Address |
2625 Butterfield Rd Ste 301n Oak Brook IL 60523-1234 |
| Practice Telephone | 2242074180 |
| Mailing Telephone | 6304681824 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2016-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038009501 | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 02230328 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437586377 | Sam J Wang | Acupuncturist | 10261 Trademark St, Unit # B, Rancho Cucamonga, CA 91730-5805 | 2013-10-10 |
| 1174097737 | Sam Wang | Physical Therapist | 335 Court Street, Brooklyn, NY 11231 | 2019-01-17 |
| 1154440501 | Sam Chung-kang Wang | Surgery | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2007-03-28 |
| Street Address |
149 BUCKLEY RD |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508328246 | Samuel Smith | Chiropractor | 149 Buckley Rd, Libertyville, IL 60048-1400 | 2019-04-02 |
| 1053734053 | Tyler Zoesch | Chiropractor | 149 Buckley Rd, Libertyville, IL 60048-1400 | 2014-01-27 |
| 1942443577 | Chiro One Wellness Center of Libertyville LLC | Chiropractor | 149 Buckley Rd, Libertyville, IL 60048-1400 | 2009-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| 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 |
|---|---|---|---|---|
| 1548700172 | Optimize Chiropractic, PC | Chiropractor | 1746 N Milwaukee Ave, Libertyville, IL 60048-1317 | 2017-03-01 |
| 1861887796 | Tommy Edward John IIi | Chiropractor | 13960 W Rockland Rd, Libertyville, IL 60048-9724 | 2015-03-30 |
| 1316380793 | Krysty Lynne Benhart-martel | Chiropractor | 1304 Willow Ave, Libertyville, IL 60048-1714 | 2013-04-16 |
| 1033458294 | Seunghan Lim | Chiropractor | 1310 S Milwaukee Ave, Libertyville, IL 60048-3795 | 2013-02-07 |
| 1245508035 | Bosco Chiropractic Clinic PC | Chiropractor | 127 E Park Ave, Libertyville, IL 60048-2801 | 2011-12-07 |
| 1093090367 | Libertyville Wellness Group, Inc | Chiropractor | 1785 Northwind Blvd, Libertyville, IL 60048-9617 | 2011-10-18 |
| 1780812784 | North Shore Pro-active Health LLC | Chiropractor | 112 W Lake St, Libertyville, IL 60048-1812 | 2009-06-29 |
| 1760630826 | Dale Lachman | Chiropractor | 1457 N Milwaukee Ave, Libertyville, IL 60048-1310 | 2008-09-03 |
| 1417080771 | John D. Nikitow | Chiropractor | 207 E Park Ave, Libertyville, IL 60048-2803 | 2007-03-14 |
| 1013095983 | Jeffrey S Sima | Chiropractor | 1117 S Milwaukee Ave Ste D7, Libertyville, IL 60048-5257 | 2006-11-01 |
| Find all providers in LIBERTYVILLE | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
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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.