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Organization
NORTHSTAR INTEGRATED HEALTH & PHYSICAL MEDICINE CENTER, S.C.
Active
Organization
NORTHSTAR INTEGRATED HEALTH & PHYSICAL MEDICINE CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL RIESELMAN (OWNER)
(630) 795-1889
Entity
Organization
Contact information
Practice address
4513 LINCOLN AVE, #212, LISLE, IL 60532-1289
(630) 795-1889
Mailing address
4513 LINCOLN AVE, #212, LISLE, IL 60532-1289
(630) 795-1889
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
038010007
IL
163WP0000X
Pain Management Registered Nurse
041384754
IL
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
036110569
IL
207VG0400X
Gynecology Physician
036111510
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
IL
208D00000X
General Practice Physician
036111510
IL
208VP0000X
Pain Medicine Physician
036110569
IL
225100000X
Physical Therapist
070019141
IL
363LF0000X
Family Nurse Practitioner
Primary
209009686
IL
363LP2300X
Primary Care Nurse Practitioner
209009686
IL
363LX0106X
Occupational Health Nurse Practitioner
209009686
IL
Other
Enumeration date
08/02/2012
Last updated
02/11/2014
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