Healthcare Provider Details

I. General information

NPI: 1982436549
Provider Name (Legal Business Name): LABEDZ NATUROPATHIC HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12337 S ROUTE 59 UNIT 121
PLAINFIELD IL
60585-4626
US

IV. Provider business mailing address

150 RIVERSIDE DR
MONTGOMERY IL
60538-1231
US

V. Phone/Fax

Practice location:
  • Phone: 312-463-9434
  • Fax:
Mailing address:
  • Phone: 312-972-3179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JASON LABEDZ
Title or Position: OWNER
Credential: ND, MA, LCPC
Phone: 312-972-3179