Organization
COLEMAN WELLNESS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ROBERT COLEMAN D.C. (PRESIDENT)
(630) 553-7600
Entity
Organization
Contact information
Practice address
129 COMMERCIAL DR UNIT 5B, YORKVILLE, IL 60560-4731
(630) 553-7600
Mailing address
PO BOX 156, YORKVILLE, IL 60560-0156
(630) 553-7600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038004818
IL
111N00000X
Chiropractor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11895142
CAQH
—
Enumeration date
06/09/2017
Last updated
09/15/2023
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