Organization
FAMILY WELLNESS CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE HICKENLOOPER (OFFICE MANAGER)
(847) 854-8052
Entity
Organization
Contact information
Practice address
1451 MERCHANT DR, ALGONQUIN, IL 60102-5917
(847) 854-8052
(847) 854-6706
Mailing address
1451 MERCHANT DR, ALGONQUIN, IL 60102-5917
(847) 854-8052
(847) 854-6706
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
—
IL
111NN1001X
Nutrition Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4529988
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/18/2007
Last updated
01/01/2008
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