Organization · NPI-2

Active Wellness, LLC

Chiropractor · Chicago, IL

NPI number1902162662
StatusActive
Last updated in NPPESFeb 14, 2014

Details

NPI
1902162662
Entity type
Organization (NPI-2)
Legal business name
Active Wellness, LLC
Organization subpart
No
Enumeration date
Apr 6, 2012
Last updated
Feb 14, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor24800594ILYes
111NN1001X Chiropractor, Nutrition24800594IL
111NP0017X Chiropractor, Pediatric Chiropractor24800594IL
171100000X Acupuncturist––

Practice location

4555 N Lincoln Ave
Chicago, IL 60625-2102

Phone 773-328-8153

Mailing address

4555 N Lincoln Ave
Chicago, IL 60625-2102

Phone 773-328-8153

Authorized official

Andrew Ingley
General Manager
8132209113

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Chiropractor providers in Chicago, IL