Healthcare Provider Details

I. General information

NPI: 1174452528
Provider Name (Legal Business Name): TBD FITNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 E HIGGINS RD
ELK GROVE VILLAGE IL
60007-1551
US

IV. Provider business mailing address

832 E HIGGINS RD
ELK GROVE VILLAGE IL
60007-1551
US

V. Phone/Fax

Practice location:
  • Phone: 224-366-7655
  • Fax:
Mailing address:
  • Phone: 224-366-7655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: DANIEL CHILLE
Title or Position: FOUNDER
Credential:
Phone: 331-702-1233