Healthcare Provider Details
I. General information
NPI: 1154561892
Provider Name (Legal Business Name): TOTAL HEALTH INSTITUTE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2009
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23W525 SAINT CHARLES RD
CAROL STREAM IL
60188-2867
US
IV. Provider business mailing address
23W525 SAINT CHARLES RD.
WHEATON IL
60188
US
V. Phone/Fax
- Phone: 630-871-0000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | 038005294 |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
KEITH
NEMEC
Title or Position: PRESIDENT
Credential: D.C.
Phone: 630-871-0000