Healthcare Provider Details

I. General information

NPI: 1497221733
Provider Name (Legal Business Name): JO NELL MARIE COOL DC, ND, CACCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2018
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 N LINCOLN AVE
CHICAGO IL
60625-2102
US

IV. Provider business mailing address

7304 MCCLELLAN RD
WELLINGTON CO
80549-2233
US

V. Phone/Fax

Practice location:
  • Phone: 773-328-8153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND.0000190
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0007843
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR0007843
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: