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General NPI Number Information
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NPI Number | 1447021654
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Entity Type | Organization
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Legal Business Name | NEXGEN WELLNESS & SPORTS MEDICINE
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 3200 W HIGGINS RD STE 101
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-2174
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Country | US
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Telephone | 925-408-2909
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Fax |
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Provider Business Mailing Address
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Address Line | 840 MICHIGAN AVE APT 5
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City | EVANSTON
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State | IL
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Zip | 60202-2588
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Country | US
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Telephone | 224-222-1799
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Fax | 224-714-0628
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. WILLIAM STEVEN MURILLO
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Credential | DC
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Telephone | 925-408-2909
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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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