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General NPI Number Information
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NPI Number | 1528123973
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Entity Type | Organization
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Legal Business Name | FOR YOUR HEALTH & WELLNESS
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 401 W ONTARIO ST SUITE 220
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City | CHICAGO
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State | IL
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Zip | 60654
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Country | US
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Telephone | 312-255-1580
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Fax | 312-255-0783
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Provider Business Mailing Address
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Address Line | 401 W ONTARIO ST SUITE 220
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City | CHICAGO
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State | IL
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Zip | 60654-6957
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Country | US
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Telephone | 312-255-1580
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Fax | 312-255-0783
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY A DUGAS SR.
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Credential | MD
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Telephone | 312-255-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036071610
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License Number State | IL
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