Organization
BROADLEAF HEALTH AND WELLNESS
Active
Other names
Broadleaf Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ESPEJO OT/CCCPA (REHAB PRACTITIONER)
(773) 947-4607
Entity
Organization
Contact information
Practice address
3245 GROVE AVE STE 205, BERWYN, IL 60402-3476
(773) 947-4607
Mailing address
3245 GROVE AVE STE 205, BERWYN, IL 60402-3476
(773) 947-4607
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
PERSONAL INSURANCE
—
05
—
00
—
IL
Enumeration date
11/06/2020
Last updated
11/11/2024
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