Healthcare Provider Details

I. General information

NPI: 1497521967
Provider Name (Legal Business Name): NOVO HEALTH & PERFORMANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 04/07/2024
Certification Date: 04/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 W ROOSEVELT RD STE 126
WEST CHICAGO IL
60185-4834
US

IV. Provider business mailing address

245 W ROOSEVELT RD STE 126
WEST CHICAGO IL
60185-4834
US

V. Phone/Fax

Practice location:
  • Phone: 630-660-6574
  • Fax:
Mailing address:
  • Phone: 630-660-6574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JESUS D FERNANDEZ
Title or Position: OWNER
Credential: DC
Phone: 630-660-6574