# MENS HEALTH CHICAGO LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1104111848
- **Authorized official:** JR WADE (MEMBER)
- **Authorized official phone:** (480) 229-1986

## Contact information

- **Practice address:** 1396 NEWCASTLE CT, BARTLETT, IL 60103-2989
- **Practice address phone:** (480) 229-2013
- **Mailing address:** 12878 N 119TH ST, SCOTTSDALE, AZ 85259-2736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | AP3397 | AZ | Yes |

## Other

- **Enumeration date:** 06/10/2011
- **Last updated:** 06/10/2011