Organization
PROHEALTH PREVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA NICOLINI (PRESIDENT/CEO)
(574) 993-7992
Entity
Organization
Contact information
Practice address
1943 S MAY ST, 1F, CHICAGO, IL 60608-3359
(312) 549-8866
(312) 549-8861
Mailing address
1943 S MAY ST, 1F, CHICAGO, IL 60608-3359
(312) 549-8866
(312) 549-8861
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203002034
—
IL
Enumeration date
01/12/2016
Last updated
02/10/2021
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