# ELITE SPINE & WELLNESS CENTER, INC

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

## Provider details

- **NPI number:** 1568069805
- **Authorized official:** BRITTANY SULLIVAN DC (OWNER)
- **Authorized official phone:** (181) 598-8783

## Contact information

- **Practice address:** 6833 STALTER DR STE 203, ROCKFORD, IL 61108-2582
- **Practice address phone:** (815) 904-6650
- **Practice address fax:** (815) 904-6564
- **Mailing address:** 6833 STALTER DR STE 203, ROCKFORD, IL 61108-2582
- **Mailing address phone:** (815) 904-6650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2020
- **Last updated:** 01/20/2021