Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southport Grace Chiropractic and Wellness LLC

Organization Chiropractor · NPI 1629539291

Southport Grace Chiropractic and Wellness LLC is a Chiropractor in Chicago, Illinois. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1209 W Grace St
Chicago, IL 60613-2805
Phone: (772) 525-2225
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X

Record details

NPI number1629539291
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Keith Olding — Chiropractor · (419) 628-4003
NPI enumeratedMarch 27, 2019
Last updated in NPPESMay 8, 2019
Mailing address1209 W Grace St Ste 1, Chicago, IL 60613-2805

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