Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southport Grace Chiropractic and Wellness LLC

Organization Chiropractor · NPI 1629539291

Southport Grace Chiropractic and Wellness LLC provides Chiropractor services 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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