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LAKEFRONT CHIROPRACTIC CENTER
NPI 1457530628
Chiropractor in Glencoe, IL

Active since October 24, 2007
630 VERNON AVE, SUITE F, GLENCOE, IL 60022(847) 835-4700(847) 835-8408 Get Directions Write a Review

NPPES record last updated: September 22, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Lakefront Chiropractic Center NPPES

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

LAKEFRONT CHIROPRACTIC CENTER (NPI 1457530628) is a healthcare organization registered as a chiropractor in Glencoe, Illinois and active in the NPI registry since October 2007. The organization lists Joseph John Ethen, President, as its authorized official.

NPPES Registry Identity

NPI1457530628
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameETHEN CHIROPRACTIC & WELLNESS, SC
Location Address630 VERNON AVE, SUITE FGlencoe, IL 60022
Mailing Address630 Vernon Ave, Suite FGlencoe, IL 60022 · (847) 835-4700 · Fax (847) 835-8408
Phone(847) 835-4700
Fax(847) 835-8408
Organization SubpartNo
Authorized OfficialJoseph John EthenPresident · (847) 835-4700
Enumeration DateOctober 24, 2007
Last NPPES UpdateSeptember 22, 2011
✔ NPI 1457530628 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.
630 VERNON AVE, Glencoe, IL 60022
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Other Names 1

Doing Business AsLakefront Chiropractic Center

Other Identifiers 1

Other9358811OH · Medicare Group Number

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)

Lakefront Chiropractic Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lakefront Chiropractic Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

Joseph Ethen, D.C.
Chiropractic
NPI 1700845047
662 VERNON AVE
Glencoe, IL 60022
(847) 835-4700
0.1 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 Ethen Chiropractic & Wellness, Sc's NPI number?

The NPI number for Ethen Chiropractic & Wellness, Sc is 1457530628. It was assigned to this organization in the NPPES registry on October 24, 2007. The provider is doing business as Lakefront Chiropractic Center.

Where is Ethen Chiropractic & Wellness, Sc located?

Ethen Chiropractic & Wellness, Sc is located at 630 Vernon Ave Suite F, Glencoe, IL 60022. The listed phone number is (847) 835-4700.

What is Ethen Chiropractic & Wellness, Sc's specialty?

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

Is Ethen Chiropractic & Wellness, Sc enrolled in Medicare?

Yes. Ethen Chiropractic & Wellness, Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ethen Chiropractic & Wellness, Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Ethen Chiropractic & Wellness, Sc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ethen Chiropractic & Wellness, Sc was last updated on September 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.