Organization
ADVANCED WELLNESS CENTER, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMY XIAOTIAN WANG DC (OWNER)
(847) 274-5464
Entity
Organization
Contact information
Practice address
6325 MAIN ST STE 120, WOODRIDGE, IL 60517-1299
(630) 541-6773
(630) 541-1748
Mailing address
6325 MAIN ST STE 120, WOODRIDGE, IL 60517-1299
(630) 541-6773
(630) 541-7485
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011299
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038011299
PROVIDER LICENSE NUMBER
IL
01
—
F100244107
MEDICARE PTAN
IL
Enumeration date
01/07/2013
Last updated
10/13/2015
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