VIDA PUODZIUNAS (NPI# 1528064110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528064110 |
| Entity Type | Individual |
| Full Name | VIDA PUODZIUNAS |
| Credential | D.C. |
| Practice Address |
16626 W 159th St Suite 700 Lockport IL 60441-8018 |
| Practice Telephone | 8158349075 |
| Practice Fax Number | 8158349077 |
| Mailing Telephone | 8158349075 |
| Mailing Fax Number | 8158349077 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2015-04-01 |
| NPI Deactivation Date | 03/17/2006 |
| NPI Reactivation Date | 2006-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038009499 | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE NUMBER | 038009499 | 01 |
| Street Address |
16626 W 159TH ST SUITE 700 |
| City | LOCKPORT |
| State | IL |
| Zip Code | 60441-8018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114381191 | Chijioke Jimonu | Nurse Practitioner | 16626 W 159th St, Suite 700, Lockport, IL 60441-8018 | 2016-04-06 |
| 1770860124 | Healthy Connection Physical Medicine Inc | General Practice | 16626 W 159th St, Suite700, Lockport, IL 60441-8018 | 2011-11-14 |
| 1417268236 | Shark's Eye Establishment Corp. | Chiropractor | 16626 W 159th St, Suite 700, Lockport, IL 60441-8018 | 2010-06-25 |
| 1992994891 | Lockport Dialysis LLC | Clinic/Center | 16626 W 159th St, Ste 703, Lockport, IL 60441-8018 | 2007-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366951840 | Samantha Jo Gehrig | Counselor | 16504 W 146th Pl, Lockport, IL 60441 | 2017-09-27 |
| 1275939415 | Walid Habbal | Dentist | 12612 S. Harlem Ave, Palos Heights, IL 60441 | 2014-11-17 |
| 1205240975 | Angelica Wujcik | Chiropractor | 420 Summit Drive, Lockport, IL 60441 | 2014-06-20 |
| 1720418916 | Melissa Obrien | Dietitian, Registered | 16221 W 159th St Ste 102, Lockport, IL 60441 | 2013-11-25 |
| 1033467535 | Trinity Services Inc. | Clinic/Center | 1017 S State St., Lockport, IL 60441 | 2012-08-15 |
| 1013219427 | Christopher David Baran | Nurse Anesthetist, Certified Registered | 1114 East Treeline Drive, Lockport, IL 60441 | 2010-11-18 |
| 1871736868 | Advanced Family Dental & Chiropractic of Lockport PC | Dentist | 730 South Washington St, Lockport, IL 60441 | 2009-04-07 |
| 1922292432 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 16241 South Farrell Rd, Lockport, IL 60441 | 2007-08-29 |
| 1407979438 | Joanne Adel Nasra | Developmental Therapist | 16136 Bent Grass Drive, Lockport, IL 60441 | 2007-04-06 |
| 1497800536 | Patrick Francis Healy | Dentist | 916 7th St, Lockport, IL 60441 | 2007-01-25 |
| Find all providers in zip 60441 | ||||
| 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 |
|---|---|---|---|---|
| 1730730037 | Derrick James Mcaninch | Chiropractor | 6933 Tonawanda Creek Rd, Lockport, NY 14094-7959 | 2019-09-27 |
| 1275015646 | Jordan Adam Kurbs | Chiropractor | 741 Davison Rd., Lockport, NY 14094-5214 | 2018-09-03 |
| 1386027878 | Michael T Trombitas | Chiropractor | 244 Bewley Building, Market Street, Lockport, NY 14094 | 2015-07-02 |
| 1205240975 | Angelica Wujcik | Chiropractor | 420 Summit Drive, Lockport, IL 60441 | 2014-06-20 |
| 1962724088 | Amna P Riches | Chiropractor | 5854 Snyder Drive, Suite A, Lockport, NY 14094 | 2010-02-16 |
| 1982936357 | Amanda Erin Domm | Chiropractor | 5854 Snyder Dr, Lockport, NY 14094-9497 | 2010-02-09 |
| 1487884037 | Geoffrey James Klaffka | Chiropractor | 6332 S Transit Rd, Lockport, NY 14094-6336 | 2009-07-16 |
| 1801030713 | Joseph Family Chiropractic, Pllc | Chiropractor | 6513 Campbell Blvd, Lockport, NY 14094-9210 | 2009-04-22 |
| 1528207636 | Stephen Mahalik Dc Ltd | Chiropractor | 515 S State St, Lockport, IL 60441-3032 | 2009-02-12 |
| 1891917795 | Loren Davis | Chiropractor | 16622 W. 159th St., Suite 500, Lockport, IL 60441-8015 | 2007-05-02 |
| Find all providers in LOCKPORT | ||||
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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.