Fuller Health Group LLC
Chiropractor, Nutrition in Chicago, IL. Organization (NPI-2).
NPI number1962647792
StatusActive
Last updated in NPPESDec 8, 2008
Details
- NPI
- 1962647792
- Entity type
- Organization (NPI-2)
- Legal business name
- Fuller Health Group LLC
- Organization subpart
- No
- Enumeration date
- Dec 8, 2008
- Last updated
- Dec 8, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111NN1001X | Chiropractor, Nutrition | 038010329 | IL | Yes |
Practice location
12 W Maple StChicago, IL 60610-4691
Phone 312-587-3500
Mailing address
Po Box 349Oak Park, IL 60303-0349
Phone 708-705-9494 · Fax 708-386-2768
Authorized official
Brian Jay Fuller
President
7087059494
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