Healthcare Provider Details

I. General information

NPI: 1477549236
Provider Name (Legal Business Name): COMPLETE WELLNESS MEDICAL CENTER OF STERLING SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2522 E LINCOLNWAY SUITE G
STERLING IL
61081-3058
US

IV. Provider business mailing address

2522 E LINCOLNWAY
STERLING IL
61081-3058
US

V. Phone/Fax

Practice location:
  • Phone: 815-626-6630
  • Fax: 815-626-6796
Mailing address:
  • Phone: 815-626-6630
  • Fax: 815-626-6796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number042616717
License Number StateIL

VIII. Authorized Official

Name: DR. THOMAS D. FINNEY
Title or Position: PRESIDENT
Credential: DC
Phone: 815-626-6630