Organization
WELLNESS RESTORATION CENTERS OF ILLINOIS, LLC
Active
Parent organization
VAN NESS ENTREPRISES, LLP
Organization subpart
Yes
Provider details
NPI number
Legal business name
VAN NESS ENTREPRISES, LLP
Authorized official
RANDEE P VAN NESS MS (CEO)
(719) 651-5102
Entity
Organization
Contact information
Practice address
700A S ILLINOIS ST, BELLEVILLE, IL 62220-2142
(618) 277-6300
(618) 277-6302
Mailing address
700A S ILLINOIS ST, BELLEVILLE, IL 62220-2142
(618) 277-6300
(618) 277-6302
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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