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

Mr. Nickolas William Severino, DC

Individual provider Chiropractor · NPI 1376207795

Mr. Nickolas William Severino, DC is a Chiropractic in Park Ridge, Illinois. Qualified in 2021, 5 years ago. Practices with Active Wellness LLC, a 22-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2021
What do these letters mean?
DC — Doctor of Chiropractic
A licensed chiropractor.

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Practice location Address checks out

40 N Northwest Hwy
Park Ridge, IL 60068-3329
Phone: (847) 737-1023
Fax: (847) 737-1024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence 038.013758 (IL)

Record details

NPI number1376207795
Entity typeIndividual (Type 1)
GenderMale
Credentials DC
Sole proprietorNo
NPI enumeratedOctober 22, 2021
Last updated in NPPESAugust 19, 2024
Certification dateAugust 19, 2024
Mailing address40 N Northwest Hwy, Park Ridge, IL 60068-3329

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCHIROPRACTIC
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Active Wellness Llc — 22 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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