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Organization
WHOLEHEALTH CHICAGO-3
Active
Organization
WHOLEHEALTH CHICAGO-3
Active
Other names
WholeHealth Chicago 3 SC
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KEITH EDELBERG MD (SECRETARY)
(773) 296-6700
Entity
Organization
Contact information
Practice address
2522 N LINCOLN AVE, CHICAGO, IL 60614-2352
(773) 296-6700
(773) 296-1131
Mailing address
2565 N CLYBOURN AVE, CHICAGO, IL 60614-3052
(773) 296-6700
(773) 296-1131
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
111N00000X
Chiropractor
—
—
133N00000X
Nutritionist
—
—
171100000X
Acupuncturist
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1623831
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/04/2006
Last updated
07/15/2021
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