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General NPI Number Information
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NPI Number | 1417022518
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Entity Type | Organization
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Legal Business Name | INCLUSIVE WELLNESS, LTD.
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 4705 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2009
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Country | US
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Telephone | 888-978-8287
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Fax |
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Provider Business Mailing Address
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Address Line | 1603 ORRINGTON AVE STE 600
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City | EVANSTON
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State | IL
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Zip | 60201-3860
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Country | US
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Telephone | 312-774-0010
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SOHEILA VAHABI
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Credential | MS, DC, FIAMA
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Telephone | 312-774-0010
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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 | 038008001
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License Number State | IL
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