Organization
WELL-ROOTED FUNCTIONAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PAWLICKI NP (OWNER)
(815) 529-1201
Entity
Organization
Contact information
Practice address
110 S JOHNSON ST STE 207, WOODSTOCK, IL 60098-3259
(815) 355-1605
Mailing address
110 S JOHNSON ST STE 207, WOODSTOCK, IL 60098-3259
(815) 355-1605
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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