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General NPI Number Information
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NPI Number | 1205534559
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Entity Type | Organization
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Legal Business Name | ELEMENT CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 333 E IL ROUTE 83 STE B5
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City | MUNDELEIN
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State | IL
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Zip | 60060-4299
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Country | US
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Telephone | 805-746-6722
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Fax |
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Provider Business Mailing Address
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Address Line | 64 S PRAIRIE AVE
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City | MUNDELEIN
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State | IL
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Zip | 60060-2768
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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 | CEO
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Name | KATHLEEN NESTINGEN
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Credential |
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Telephone | 805-746-6722
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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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