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General NPI Number Information
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NPI Number | 1679705859
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Entity Type | Organization
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Legal Business Name | IHEALTH SC
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 1283 E OGDEN AVE SUITE 183
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City | NAPERVILLE
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State | IL
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Zip | 60563-1616
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Country | US
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Telephone | 630-877-0677
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Fax | 630-548-2427
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Provider Business Mailing Address
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Address Line | 1283 E OGDEN AVE SUITE 183
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City | NAPERVILLE
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State | IL
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Zip | 60563-1616
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Country | US
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Telephone | 630-877-0677
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Fax | 630-548-2427
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAMARA ANN WOLLER-LI
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Credential | D.C.
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Telephone | 630-877-0677
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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 | 038.010268
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License Number State | IL
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