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General NPI Number Information
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NPI Number | 1295525780
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Entity Type | Organization
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Legal Business Name | IGH WELLNESS INC
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 486 W BOUGHTON RD # A1-A3
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City | BOLINGBROOK
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State | IL
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Zip | 60440-2399
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Country | US
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Telephone | 630-864-6486
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Fax | 331-757-5092
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Provider Business Mailing Address
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Address Line | 486 W BOUGHTON RD # A1-A3
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City | BOLINGBROOK
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State | IL
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Zip | 60440-2399
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Country | US
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Telephone | 630-864-6486
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Fax | 331-757-5092
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Authorized Official
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Title or Position | OWNER
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Name | SHAQUALA REESE
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Credential | DC
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Telephone | 630-864-6486
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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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