Organization
ENVISION HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY C FLETCHER DC (OWNER)
(224) 544-5033
Entity
Organization
Contact information
Practice address
840 S WAUKEGAN RD, #201, LAKE FOREST, IL 60045-2608
(224) 544-5033
Mailing address
840 S WAUKEGAN RD, #201, LAKE FOREST, IL 60045-2608
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038011833
IL
111N00000X
Chiropractor
Primary
038012962
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038011833
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
—
038012962
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
05/02/2016
Last updated
05/02/2016
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