Healthcare Provider Details

I. General information

NPI: 1588615264
Provider Name (Legal Business Name): TRILLIUM HEALTH & WELLNESS, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E NORTH ST STE. B
ELBURN IL
60119-9052
US

IV. Provider business mailing address

701 E NORTH ST STE. B
ELBURN IL
60119-9052
US

V. Phone/Fax

Practice location:
  • Phone: 630-365-5820
  • Fax: 630-365-5815
Mailing address:
  • Phone: 630-365-5820
  • Fax: 630-365-5815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIKA K MENNERICK
Title or Position: PRESIDENT
Credential: DC
Phone: 630-365-5820