Illinois Wellness Group Of Joliet, Ltd
General Practice in Joliet, IL. Organization (NPI-2).
NPI number1215342829
StatusActive
Last updated in NPPESOct 2, 2015
Details
- NPI
- 1215342829
- Entity type
- Organization (NPI-2)
- Legal business name
- Illinois Wellness Group Of Joliet, Ltd
- Organization subpart
- No
- Enumeration date
- Jun 23, 2014
- Last updated
- Oct 2, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Other names
- Joliet Medical Center (Doing Business As)
Practice location
815 N Larkin AveSuite 105
Joliet, IL 60435-3438
Phone 815-714-2271 · Fax 815-582-3262
Mailing address
815 N Larkin AveSuite 105
Joliet, IL 60435-3438
Phone 815-714-2271 · Fax 815-582-3262
Authorized official
Brett Nolan Nash
Owner
8157142271
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