# FUNCTIONAL FITNESS OF DUPAGE, INC

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

## Provider details

- **NPI number:** 1861960601
- **Authorized official:** TANNER SHULTZ MS, CSCS (CLINICAL EXERCISE PHYSIOLOGIST)
- **Authorized official phone:** (630) 390-8417

## Contact information

- **Practice address:** 27W157 WALNUT DR, WINFIELD, IL 60190-2051
- **Practice address phone:** (630) 390-8417
- **Mailing address:** 27W157 WALNUT DR, WINFIELD, IL 60190-2051
- **Mailing address phone:** (630) 390-8417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/09/2018
- **Last updated:** 11/09/2018