Organization
WELLNESS INSTITUTE OF ILLINOIS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE M LAVINE M.D. (MEDICAL DIRECTOR)
(815) 477-8844
Entity
Organization
Contact information
Practice address
110 W HILLCREST BLVD, SUITE 102, SCHAUMBURG, IL 60195-3105
(815) 687-6735
(815) 308-3387
Mailing address
741 S MCHENRY AVE, SUITE G, CRYSTAL LAKE, IL 60014-7445
(815) 477-8844
(815) 308-3387
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
36.0422751
IL
261QP3300X
Pain Clinic/Center
Primary
036-049364
IL
Other
Enumeration date
06/12/2015
Last updated
11/28/2016
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