# ILLINOIS WELLNESS GROUP OF NAPERVILLE, S.C.

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

## Provider details

- **NPI number:** 1760744106
- **Authorized official:** DR. JEFFREY M GLAUS D.C. (PRESIDENT)
- **Authorized official phone:** (480) 227-7144

## Contact information

- **Practice address:** 3416 S ROUTE 59, SUITE 108, NAPERVILLE, IL 60564-8148
- **Practice address phone:** (630) 416-1151
- **Practice address fax:** (630) 416-1158
- **Mailing address:** 3416 S ROUTE 59, SUITE 108, NAPERVILLE, IL 60564-8148
- **Mailing address phone:** (630) 416-1151
- **Mailing address fax:** (630) 416-1158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 06/12/2012
- **Last updated:** 06/28/2013