# RAVENSWOOD HEALTH AND WELLNESS CENTER, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093126435
- **Authorized official:** DR. JASON GRIFFITH FENNEMA D.C. (PRESIDENT)
- **Authorized official phone:** (773) 456-5313

## Contact information

- **Practice address:** 4256 N RAVENSWOOD AVE, UNIT 101, CHICAGO, IL 60613-1110
- **Practice address phone:** (773) 327-2225
- **Practice address fax:** (773) 327-7554
- **Mailing address:** 4256 N RAVENSWOOD AVE, UNIT 101, CHICAGO, IL 60613-1110
- **Mailing address phone:** (773) 327-2225
- **Mailing address fax:** (773) 327-7554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | 1386657690 | IL | Yes |

## Other

- **Enumeration date:** 05/19/2014
- **Last updated:** 12/30/2014