CHIRO ONE WELLNESS CENTER METRO OF OLD TOWN LLC
NPI 1063435402
Chiropractor in Chicago, IL

Q: What is Chiro One Wellness Center Metro Of Old Town LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since July 26, 2006

1522 N HALSTED ST, CHICAGO, IL 60642(312) 379-5000 Get Directions Write a Review

NPPES record last updated: October 24, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Chiro One Wellness Center Metro Of Old Town Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHIRO ONE WELLNESS CENTER METRO OF OLD TOWN LLC (NPI 1063435402) is a healthcare organization registered as a chiropractor in Chicago, Illinois and active in the NPI registry since July 2006. The organization lists Sam Wang, Coo, as its authorized official.

NPPES Registry Identity

NPI1063435402

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameCHIRO ONE WELLNESS CENTER METRO OF OLD TOWN LLC

Location Address1522 N HALSTED STChicago, IL 60642-2528

Mailing Address2625 Butterfield Rd, Ste 301nOak Brook, IL 60523-1234 · (630) 468-1824 · Fax (630) 320-6489

Phone(312) 379-5000

Organization SubpartNo

Authorized OfficialSam WangCoo · (630) 468-1824

Enumeration DateJuly 26, 2006

Last NPPES UpdateOctober 24, 2017

✔ NPI 1063435402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

Definition

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.

1522 N HALSTED ST, Chicago, IL 60642

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chiro One Wellness Center Metro Of Old Town Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Chiro One Wellness Center Metro Of Old Town LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Sara Siddiqui, D.C.

Chiropractic

NPI 1083985824

1522 N HALSTED ST
Chicago, IL 60642

(312) 379-5000

✔ Accepts MedicareSame address

Adam Granville, DC

Chiropractic

NPI 1740926179

1817 N 169TH PLZ STE B
Omaha, NE 68118

(402) 932-8108

444 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chiro One Wellness Center Metro Of Old Town LLC's NPI number?

The NPI number for Chiro One Wellness Center Metro Of Old Town LLC is 1063435402. It was assigned to this organization in the NPPES registry on July 26, 2006.

Where is Chiro One Wellness Center Metro Of Old Town LLC located?

Chiro One Wellness Center Metro Of Old Town LLC is located at 1522 N Halsted St, Chicago, IL 60642. The listed phone number is (312) 379-5000.

What is Chiro One Wellness Center Metro Of Old Town LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Chiro One Wellness Center Metro Of Old Town LLC enrolled in Medicare?

Yes. Chiro One Wellness Center Metro Of Old Town LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Chiro One Wellness Center Metro Of Old Town LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to Chiro One Wellness Center Metro Of Old Town LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Chiro One Wellness Center Metro Of Old Town LLC was last updated on October 24, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.