Active Wellness, Llc - Medicare Chiropractor in Chicago, IL

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Active Wellness, Llc is a medicare enrolled "Chiropractor" provider in Chicago, Illinois. Their current practice location is 4555 N Lincoln Ave, Chicago, Illinois. You can reach out to their office (for appointments etc.) via phone at (773) 328-8153.

Active Wellness, Llc is licensed to practice in Illinois (license number 24800594) and it also participates in the medicare program. Active Wellness, Llc is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1902162662.

Contact Information

Active Wellness, Llc
4555 N Lincoln Ave,
Chicago, IL 60625-2102
(773) 328-8153
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameActive Wellness, Llc
TypeFacility
SpecialityChiropractor
Location4555 N Lincoln Ave, Chicago, Illinois
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1902162662
  • Provider Enumeration Date: 04/06/2012
  • Last Update Date: 02/14/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 3072752864
  • Enrollment ID: O20130627000369

Medical Identifiers

Medical identifiers for Active Wellness, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902162662NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
111N00000XChiropractor 24800594 (Illinois)Primary
111NN1001XChiropractor - Nutrition 24800594 (Illinois)Secondary
111NP0017XChiropractor - Pediatric Chiropractor 24800594 (Illinois)Secondary
171100000XAcupuncturist (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Active Wellness, Llc acts as a billing entity for following providers:
Provider NameHovig Vartanian
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1215016134
PECOS PAC ID: 5193700649
Enrollment ID: I20040621000449
Provider NameRichard H Valdez
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1679629240
PECOS PAC ID: 8325096993
Enrollment ID: I20050111000043
Provider NameDean P Cherniak
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1497804645
PECOS PAC ID: 5597719781
Enrollment ID: I20050310000387
Provider NameDanielle Dever
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1760598775
PECOS PAC ID: 3476577925
Enrollment ID: I20060123000970
Provider NameRobert L Richart
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1144302456
PECOS PAC ID: 3476555616
Enrollment ID: I20070201000094
Provider NameAdam M Bruene
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1932431210
PECOS PAC ID: 7214061134
Enrollment ID: I20100813000950
Provider NameRyan Dorough
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1942535299
PECOS PAC ID: 4981889201
Enrollment ID: I20110502000746
Provider NameRaqaq A Alebiosu
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1568731081
PECOS PAC ID: 0547401333
Enrollment ID: I20130719000533
Provider NameStaci R Ahrens
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1891838777
PECOS PAC ID: 2264663632
Enrollment ID: I20140327001839
Provider NameMarcus Steward
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1598102238
PECOS PAC ID: 5395061220
Enrollment ID: I20150311001772
Provider NameCaitlin Painchaud
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1538585864
PECOS PAC ID: 3971818923
Enrollment ID: I20150819008825
Provider NameNadrine Omar
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1902253248
PECOS PAC ID: 0143515312
Enrollment ID: I20160826001442
Provider NameJason G Rejano
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1770924276
PECOS PAC ID: 1759676802
Enrollment ID: I20160829000689
Provider NameJoseph L Glowiak
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1265985303
PECOS PAC ID: 0244510550
Enrollment ID: I20161202000948
Provider NameJeffrey Mitchell Gelband
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1417487794
PECOS PAC ID: 0941570204
Enrollment ID: I20170719000579
Provider NameElisabeth M Toth
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1255814265
PECOS PAC ID: 8224370408
Enrollment ID: I20190509000487
Provider NameKatherine Jean Emrich
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1881211837
PECOS PAC ID: 3971929670
Enrollment ID: I20200812001066
Provider NameJessica Lauren Pierce
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1841818762
PECOS PAC ID: 0244658623
Enrollment ID: I20200916003173
Provider NameDavid F Moore
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1306440276
PECOS PAC ID: 0547676462
Enrollment ID: I20210301001714
Provider NameAnthony G Kelley
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1508343948
PECOS PAC ID: 1759785546
Enrollment ID: I20210802000077
Provider NameBryan Nicholas Flammini
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1558035261
PECOS PAC ID: 8628457678
Enrollment ID: I20220621003197
Provider NameKelsie Liegh Herrera
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1518563659
PECOS PAC ID: 3173904810
Enrollment ID: I20220713000934
Provider NameArthur Monaco
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1396334231
PECOS PAC ID: 3779964424
Enrollment ID: I20220713001067
Provider NameRonald Bouffard
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1922051473
PECOS PAC ID: 5193755114
Enrollment ID: I20220714000762
Provider NameAlexis Mikrut
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1043779598
PECOS PAC ID: 2062893498
Enrollment ID: I20220718001024
Provider NameBrennan Mckinstry Martin
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1801463252
PECOS PAC ID: 0941682603
Enrollment ID: I20220728000862
Provider NameAlexandra Mackillop
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1588270227
PECOS PAC ID: 6901288018
Enrollment ID: I20220806000275
Provider NameNickolas W Severino
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1376207795
PECOS PAC ID: 8325422652
Enrollment ID: I20220905000258
Provider NameShane Bruni
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1285330886
PECOS PAC ID: 6800269044
Enrollment ID: I20230308002574
Provider NameHailey Logan Spencley
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1265219729
PECOS PAC ID: 1456703396
Enrollment ID: I20240117000523
Provider NameReid Barrett
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1104514652
PECOS PAC ID: 3678926292
Enrollment ID: I20240131001401
Provider NameNimota-lai Sulaiman
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1356123384
PECOS PAC ID: 3173067808
Enrollment ID: I20240704000409
Provider NameNicole Tatsuguchi-ongcal
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1982440087
PECOS PAC ID: 4082153812
Enrollment ID: I20240826000737
Provider NameKajal M Patel
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1679310536
PECOS PAC ID: 1153860994
Enrollment ID: I20240826001175
Provider NameJustin Christopher Campos
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1497463855
PECOS PAC ID: 1759820418
Enrollment ID: I20240826002107
Provider NameMarina Phillips
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1033725999
PECOS PAC ID: 3678986122
Enrollment ID: I20240827002313
Provider NameAngelica Christine Clark
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1417734385
PECOS PAC ID: 8224577853
Enrollment ID: I20240828000087
Provider NameCourtney Sayre
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1568224848
PECOS PAC ID: 7517406671
Enrollment ID: I20240903003516
Provider NameColton Bill Hoffenbacker
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1518411560
PECOS PAC ID: 9739477605
Enrollment ID: I20240904002994
Provider NameZoann Alexis Mader
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1720569866
PECOS PAC ID: 8426308404
Enrollment ID: I20240906000015
Provider NameAkilah N Spencer
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1386045953
PECOS PAC ID: 7416277256
Enrollment ID: I20240906001675
Provider NameChristopher A Douglas
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1285273433
PECOS PAC ID: 2062833817
Enrollment ID: I20240906002263
Provider NameBlake Butler
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1114463270
PECOS PAC ID: 4183164908
Enrollment ID: I20240909000100
Provider NameNickcold Savoir Nicholson
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1205581782
PECOS PAC ID: 3779023478
Enrollment ID: I20240909003689
Provider NameJoshua Elliott Button
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1124880406
PECOS PAC ID: 2365982097
Enrollment ID: I20240910000137
Provider NameTimothy Patrick Fetter
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1801178298
PECOS PAC ID: 7810164647
Enrollment ID: I20240910001582
Provider NameIoana Manahilova
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1740835214
PECOS PAC ID: 1557801818
Enrollment ID: I20240912003684
Provider NameCarrie Santore
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1669180352
PECOS PAC ID: 2264973841
Enrollment ID: I20240923003198
Provider NameRemington Rodela
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1932782323
PECOS PAC ID: 7719418961
Enrollment ID: I20240930001657
Provider NameMichael Alden
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1376535633
PECOS PAC ID: 0042261208
Enrollment ID: I20241024003581
Provider NameJames W Mattison
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1538120878
PECOS PAC ID: 1850342221
Enrollment ID: I20241029002956
Provider NamePriyanka Narkhede
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1851012538
PECOS PAC ID: 1254864234
Enrollment ID: I20241029003677
Provider NameJoshua Cole Johnson
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1760265722
PECOS PAC ID: 8325572415
Enrollment ID: I20241112003132
Provider NameAireal Keefer
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1467274043
PECOS PAC ID: 2860926755
Enrollment ID: I20241114003040
Provider NameScott Lyman
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1104644277
PECOS PAC ID: 3072049865
Enrollment ID: I20241203003328

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Active Wellness, Llc is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Active Wellness, Llc
4555 N Lincoln Ave,
Chicago, IL 60625-2102

Ph: (773) 328-8153		Active Wellness, Llc
4555 N Lincoln Ave,
Chicago, IL 60625-2102

Ph: (773) 328-8153

Reviews and Comments


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Phone: 773-342-3221    Fax: 773-342-3836

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.