Organization
EVOLVE CHIROPRACTIC WOODSTOCK PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN FELDE (BILLING MANAGER)
(847) 345-7676
Entity
Organization
Contact information
Practice address
2440 LAKE SHORE DRIVE, WOODSTOCK, IL 60098-2980
(815) 338-9150
Mailing address
10705 RUTH RD, HUNTLEY, IL 60142-7156
(815) 338-9150
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-012415
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730526104
INDIVIDUAL NPI
—
Enumeration date
07/10/2018
Last updated
05/29/2024
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