Healthcare Provider Details

I. General information

NPI: 1770311763
Provider Name (Legal Business Name): HEALTHY STICKS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 S MAIN ST STE 101
LOMBARD IL
60148-3325
US

IV. Provider business mailing address

929 S MAIN ST STE 101
LOMBARD IL
60148-3325
US

V. Phone/Fax

Practice location:
  • Phone: 630-447-9857
  • Fax:
Mailing address:
  • Phone: 630-447-9857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. TIFFANI BECERRA ALWAZAN
Title or Position: MANAGING MEMBER
Credential: DC, ND, LAC
Phone: 630-447-9857