MEDICARE: UNIVERSAL WELLNESS, INC.

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	111N00000X	Chiropractor		IL

General Provider Information

NPI Number	:	1629152350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL WELLNESS, INC.

Provider Business Mailing Address
First Line	:	940 S ARTHUR AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2829
Country	:	US
Telephone Number	:	847-398-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 S ARTHUR AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2829
Country	:	US
Telephone Number	:	847-398-9355
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PATRICK THOMAS QUIGLEY
Credential	:	D.C
Telephone Number	:	847-398-9355

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

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