Organization
FLORENCE WELLNESS OF ILLINOIS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB HALPERT (SECRETARY)
(202) 893-7910
Entity
Organization
Contact information
Practice address
515 N STATE ST, CHICAGO, IL 60654-4854
(202) 893-7910
Mailing address
515 N STATE ST, CHICAGO, IL 60654-4854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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