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General NPI Number Information
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NPI Number | 1437029303
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Entity Type | Organization
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Legal Business Name | WRIGLEYVILLE THERAPEUTIC MASSAGE LLC
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 3300 N CLARK ST LOFT 9
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City | CHICAGO
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State | IL
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Zip | 60657-1604
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Country | US
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Telephone | 872-240-3760
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 N CLARK ST LOFT 9
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City | CHICAGO
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State | IL
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Zip | 60657-1604
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Country | US
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Telephone | 872-240-3760
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Fax |
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Authorized Official
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Title or Position | OWNER / MANAGING MEMBER
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Name | MS. CRYSTAL I SOTO
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Credential | LMT
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Telephone | 872-240-3760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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