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General NPI Number Information
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NPI Number | 1023472172
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Entity Type | Organization
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Legal Business Name | POSITIVECARING CO.
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 4548 N PAULINA ST
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City | CHICAGO
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State | IL
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Zip | 60640-5308
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Country | US
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Telephone | 847-528-5688
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Fax | 312-803-2750
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Provider Business Mailing Address
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Address Line | 4548 N PAULINA ST
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City | CHICAGO
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State | IL
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Zip | 60640-5308
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAWNA SCHWALB
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Credential | LDN
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Telephone | 847-528-5688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 164.006699
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License Number State | IL
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