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General NPI Number Information
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NPI Number | 1497521967
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Entity Type | Organization
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Legal Business Name | NOVO HEALTH & PERFORMANCE
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 04/07/2024
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Provider Practice Location Address
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Address Line | 245 W ROOSEVELT RD STE 126
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City | WEST CHICAGO
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State | IL
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Zip | 60185-4834
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Country | US
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Telephone | 630-660-6574
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Fax |
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Provider Business Mailing Address
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Address Line | 245 W ROOSEVELT RD STE 126
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City | WEST CHICAGO
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State | IL
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Zip | 60185-4834
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Country | US
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Telephone | 630-660-6574
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JESUS D FERNANDEZ
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Credential | DC
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Telephone | 630-660-6574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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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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