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General NPI Number Information
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NPI Number | 1063743342
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Entity Type | Organization
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Legal Business Name | CORE1, INC
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 1426 BROOK DR
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1025
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Country | US
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Telephone | 630-973-8626
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Fax | 800-409-4879
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Provider Business Mailing Address
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Address Line | 25244 PASTORAL DR
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City | PLAINFIELD
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State | IL
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Zip | 60585-1340
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Country | US
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Telephone | 630-973-8626
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES D WNEK JR.
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Credential |
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Telephone | 630-973-8626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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