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General NPI Number Information
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NPI Number | 1790403814
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Entity Type | Organization
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Legal Business Name | ELITE HEALTH CONSULTING CO
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 914 N LAKE ST # 10
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City | MUNDELEIN
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State | IL
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Zip | 60060-1324
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Country | US
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Telephone | 224-351-8103
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Fax |
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Provider Business Mailing Address
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Address Line | 914 N LAKE ST # 10
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City | MUNDELEIN
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State | IL
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Zip | 60060-1324
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | NOAH IM
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Credential | DC
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Telephone | 224-351-8103
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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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