Healthcare Provider Details

I. General information

NPI: 1881105302
Provider Name (Legal Business Name): PATRICK HEALTH AND WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 10/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 FLETCHER DR STE 304
ELGIN IL
60123-4756
US

IV. Provider business mailing address

2760 S HIGHLAND AVE APT 430
LOMBARD IL
60148-5433
US

V. Phone/Fax

Practice location:
  • Phone: 847-888-3131
  • Fax: 847-888-3359
Mailing address:
  • Phone: 740-360-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DEAN THOMAS PATRICK
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 847-888-3131