Healthcare Provider Details

I. General information

NPI: 1477781565
Provider Name (Legal Business Name): ACUCARE TOTAL HEALTH CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 08/05/2009
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

750 FLETCHER DR STE 304
ELGIN IL
60123-4756
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.005984
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227.001362
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227.005917
License Number StateIL

VIII. Authorized Official

Name: DR. RENEE R MCMURRY-GILMAN
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 847-888-3131