Active Wellness, LLC
Chiropractor in Chicago, IL. Organization (NPI-2).
NPI number1265847545
StatusActive
Last updated in NPPESJun 25, 2014
Details
- NPI
- 1265847545
- Entity type
- Organization (NPI-2)
- Legal business name
- Active Wellness, LLC
- Organization subpart
- No
- Enumeration date
- Jun 25, 2014
- Last updated
- Jun 25, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
| 111NN1001X | Chiropractor, Nutrition | – | – | |
| 111NP0017X | Chiropractor, Pediatric Chiropractor | – | – | |
| 111NS0005X | Chiropractor, Sports Physician | – | – | |
| 111NX0800X | Chiropractor, Orthopedic | – | – | |
| 171100000X | Acupuncturist | – | – |
Practice location
4555 N Lincoln AveChicago, IL 60625-2102
Phone 773-273-6734 · Fax 773-596-1348
Mailing address
118 S Clinton StUnit 100
Chicago, IL 60661-3628
Phone 773-598-4387 · Fax 773-596-1348
Authorized official
Andrew Ingley
Manager
7732736734
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