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General NPI Number Information
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NPI Number | 1992041941
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Entity Type | Organization
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Legal Business Name | DK WELLNESS INC
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Dates
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Enumeration Date | 12/19/2012
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 1523 ESSINGTON RD
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City | JOLIET
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State | IL
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Zip | 60435-2879
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Country | US
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Telephone | 815-730-3750
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Fax | 815-846-6210
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Provider Business Mailing Address
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Address Line | 1523 ESSINGTON RD
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City | JOLIET
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State | IL
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Zip | 60435-2879
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Country | US
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Telephone | 815-730-3750
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Fax | 815-846-6210
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Authorized Official
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Title or Position | BILLING
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Name | KATIE WERNER
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Credential | CPC CPMA
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Telephone | 630-261-9286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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