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General NPI Number Information
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NPI Number | 1932643061
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Entity Type | Organization
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Legal Business Name | NURTURE WOMEN'S WELLNESS
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 2566 PRAIRIE AVE
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City | EVANSTON
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State | IL
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Zip | 60201-2236
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Country | US
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Telephone | 847-461-9445
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Fax |
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Provider Business Mailing Address
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Address Line | 2566 PRAIRIE AVE
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City | EVANSTON
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State | IL
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Zip | 60201-2236
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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 | OWNER
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Name | BROOK MERKEL
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Credential | DC
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Telephone | 847-461-9445
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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 | 038012125
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License Number State | IL
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