# GENERATIONS CHIROPRACTIC WELLNESS, LLC

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

## Provider details

- **NPI number:** 1811397136
- **Authorized official:** DR. SAMANTHA ELIZABETH BRADLEY DC (CLINIC OWNER)
- **Authorized official phone:** (815) 547-6333

## Contact information

- **Practice address:** 8115 FRUIT FARM RD, BELVIDERE, IL 61008-9075
- **Practice address phone:** (815) 547-6333
- **Practice address fax:** (815) 642-5695
- **Mailing address:** 8115 FRUIT FARM RD, BELVIDERE, IL 61008-9075
- **Mailing address phone:** (815) 547-6333
- **Mailing address fax:** (815) 642-5695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 038012666 | IL | Yes |

## Other

- **Enumeration date:** 08/25/2014
- **Last updated:** 02/24/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5090934 | AETNA | IL |