MEDICARE: FREEDOM WELLNESS CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	038008415	IL

General Provider Information

NPI Number	:	1245787753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM WELLNESS CENTERS, LLC

Provider Business Mailing Address
First Line	:	1732 W ALGONQUIN RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60192-1573
Country	:	US
Telephone Number	:	630-289-2225
Fax Number	:	630-429-9730

Provider Business Practice Location Address
First Line	:	1732 W ALGONQUIN RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60192-1573
Country	:	US
Telephone Number	:	630-289-2225
Fax Number	:	630-429-9730

Authorized Official
Title or Position	:	CEO
Name	:	DR. KARL STEPHEN FORGERON
Credential	:	D.C.
Telephone Number	:	630-289-2225

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	04/20/2022

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