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NPI Code Detail

MEDICARE: NEUROLOGIC WELLNESS INSTITUTE, PLLC

MEDICARE: NEUROLOGIC WELLNESS INSTITUTE, PLLC
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
1111NN0400XNeurology Chiropractor

General Provider Information

NPI Number : 1396393682
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEUROLOGIC WELLNESS INSTITUTE, PLLC
Provider Business Mailing Address
First Line : 199 S ADDISON RD STE 106
Second Line :
City : WOOD DALE
State : IL
Zip : 60191-1978
Country : US
Telephone Number : 630-766-1552
Fax Number :
Provider Business Practice Location Address
First Line : 160 E GRAND AVE # 200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3800
Country : US
Telephone Number : 630-766-1552
Fax Number : 630-766-4220
Authorized Official
Title or Position : OWNER
Name : GEORGE MICHALOPOULOS
Credential : DC, DACNB, FABBIR
Telephone Number : 630-766-1552
Provider Enumeration Date : 08/29/2019
Last Update Date : 11/27/2019

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Directions to “NEUROLOGIC WELLNESS INSTITUTE, PLLC ” Practice Location

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