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Organization
ACTIVE WELLNESS, LLC
Active
Organization
ACTIVE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW INGLEY (MANAGER)
(773) 273-6734
Entity
Organization
Contact information
Practice address
4555 N LINCOLN AVE, CHICAGO, IL 60625-2102
(773) 273-6734
(773) 596-1348
Mailing address
118 S CLINTON ST, UNIT 100, CHICAGO, IL 60661-3628
(773) 598-4387
(773) 596-1348
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
111NN1001X
Nutrition Chiropractor
—
—
111NP0017X
Pediatric Chiropractor
—
—
111NS0005X
Sports Physician Chiropractor
—
—
111NX0800X
Orthopedic Chiropractor
—
—
171100000X
Acupuncturist
—
—
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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