Organization
PAIN AND WELLNESS GROUP 2 LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE LOTRIET (OWNER)
(630) 691-1234
Entity
Organization
Contact information
Practice address
411 W SAINT CHARLES RD, VILLA PARK, IL 60181-2432
(630) 691-1234
Mailing address
PO BOX 9, BATAVIA, IL 60510-0009
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036107014
IL
Other
Enumeration date
05/05/2015
Last updated
01/24/2017
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