SPORT & SPINE REHAB INSTITUTE (NPI# 1982952552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982952552 |
| Entity Type | Organization |
| Organization Name | SPORT & SPINE REHAB INSTITUTE |
| Practice Address |
200 E Roosevelt Rd Janse Hall Lombard IL 60148-4539 |
| Mailing Address |
Po Box 4588 Naperville IL 60567-4588 |
| Practice Telephone | 2628183795 |
| Practice Fax Number | 6302778100 |
| Mailing Telephone | 2628183795 |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |
| Authorized Official Name | DR. THOMAS SOLECKI JR. (OWNER) |
| Authorized Official Telephone | 2628183795 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NR0400X |
Chiropractor Specialization: Rehabilitation |
Chiropractic Providers | ||
| N | 111NS0005X |
Chiropractor Specialization: Sports Physician |
Chiropractic Providers | ||
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
200 E ROOSEVELT RD JANSE HALL |
| City | LOMBARD |
| State | IL |
| Zip Code | 60148-4539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720596968 | Rishi Tushar Bodalia | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148 | 2018-01-22 |
| 1588100176 | Dana Madigan | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2017-01-06 |
| 1427444785 | Dr Sj Smitherman Total Health Solutions, Sc | Chiropractor | 200 E Roosevelt Rd, Buchholz 202, Lombard, IL 60148-4539 | 2015-04-13 |
| 1538319140 | Ezra Cohen | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2008-09-19 |
| 1811176498 | Patricia A Coe | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2007-10-30 |
| 1700080926 | Vincent Frank Debono | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2007-06-12 |
| 1982727806 | Tari S Reinke | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2007-04-07 |
| 1316079775 | National University of Health Sciences | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2007-03-12 |
| 1821151499 | Yihyun Kwon | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2006-12-18 |
| 1033289475 | Evangelia Skokos | Chiropractor | 200 E Roosevelt Rd, Lombard, IL 60148-4539 | 2006-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336778919 | Alish Kuply | Pharmacist | 2050 S Finley Rd Suite 20, Lombard, IL 60148 | 2020-04-06 |
| 1114567880 | Danielle Slansky | Speech-Language Pathologist | 401 N. Main St, Lombard, IL 60148 | 2020-01-10 |
| 1245715572 | Ellen Mary Corey | Behavior Technician | 627 S Grace St., Lombard, IL 60148 | 2018-10-02 |
| 1194204461 | Vip 2u, Inc | Internal Medicine | 477 E Butterfield Rd Ste 400, Lombard, IL 60148 | 2018-08-08 |
| 1881185684 | Samantha Lanagan | Behavior Technician | 21 W 356 Sidney Ave, Lombard, IL 60148 | 2018-05-29 |
| 1629570114 | Iris Victoria Goss | Hearing Instrument Specialist | 412 E. Roosevelt Rd, Lombard, IL 60148 | 2018-03-01 |
| 1780102350 | Richard Wong | Dentist | 845 S. Main St #300, Lombard, IL 60148 | 2017-09-05 |
| 1033637038 | Lora Lea Biesenkamp | Counselor | 450 E 22nd St Ste 150-17, Lombard, IL 60148 | 2017-08-30 |
| 1609392836 | Shafiq Ur Rehman | Specialist/Technologist, Other | 2005 South Finley Rd Unit 1012, Lombard, IL 60148 | 2017-08-18 |
| 1033642715 | Great Lakes Living Solutions Corp. | Home Health | 477 E. Butterfield Rd., Suite Ll005, Lombard, IL 60148 | 2017-04-09 |
| Find all providers in zip 60148 | ||||
| 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 |
|---|---|---|---|---|
| 1184264707 | Christopher M Hartman | Chiropractor | 403 W Harrison Rd, Lombard, IL 60148-3215 | 2020-01-11 |
| 1548713373 | Clinton Orsini | Chiropractor | 555 E Butterfield Rd Ste 120, Lombard, IL 60148-5680 | 2016-07-28 |
| 1528419611 | Amandeep Sangha | Chiropractor | 1080 Foxworth Blvd, Lombard, IL 60148-4818 | 2016-06-29 |
| 1649673518 | Lacey Ebert | Chiropractor | 1263 S Highland Ave Ste 1d, Lombard, IL 60148-4572 | 2014-10-06 |
| 1184023046 | Yuri Korvatko | Chiropractor | 2015 S Finley Rd Apt 605, Lombard, IL 60148-4850 | 2014-08-17 |
| 1407131386 | Jennifer Ma | Chiropractor | 200 East Roosevelt Rd, Lombard, IL 60148 | 2011-10-11 |
| 1093023640 | Kateri Ashvin Porto | Chiropractor | 2720 South Highland Ave, Suite 767, Lombard, IL 60148-4539 | 2010-09-16 |
| 1699910638 | Anna Rodecki | Chiropractor | 1313 S Rebecca Rd # 216, Lombard, IL 60148-4439 | 2008-12-04 |
| 1760652077 | Michael James Lotito | Chiropractor | 61 S Highland Ave, Lombard, IL 60148-3042 | 2008-03-04 |
| 1619162823 | Joseph Paul Stiefel | Chiropractor | 837 S Westmore Ave, Suite 12, Lombard, IL 60148-3724 | 2007-09-11 |
| Find all providers in LOMBARD | ||||
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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.