Healthcare Provider Details

I. General information

NPI: 1992046494
Provider Name (Legal Business Name): NATURAL MEDICINE GROUP SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3976 RFD SUITE D
LONG GROVE IL
60047-8134
US

IV. Provider business mailing address

3976 RFD SUITE D
LONG GROVE IL
60047-8134
US

V. Phone/Fax

Practice location:
  • Phone: 847-840-3252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038012320
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227013647
License Number StateIL

VIII. Authorized Official

Name: DR. CRAIG OSWALD
Title or Position: OWNER
Credential: D.C.
Phone: 847-840-3252