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OMEGA SPINE REHAB SC NPI 1316052079


NPI Information

NPI: 1316052079
Provider Name: OMEGA SPINE REHAB SC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
9346 WAUKEGAN RD
MORTON GROVE, IL
ZIP 60053
Phone: (847) 967-8899
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OMEGA SPINE REHAB SC is a chiropractor in Morton Grove, IL. The provider is 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. OMEGA SPINE REHAB SC NPI is 1316052079. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9346 WAUKEGAN RD
MORTON GROVE, IL
ZIP 60053
Phone: (847) 967-8899
Fax: (847) 967-1980

The provider's authorized official is Larry Yun .
The authorized official title is President and has the following contact phone number (847) 967-8899.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17733360OTHERILLINOISAETNA
20001634109OTHERILLINOISBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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