MEDICARE: FREEDOM WELLNESS CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038008415	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1477522126	OTHER	IL	INDIVIDUAL NPI
2	1245787753	OTHER	IL	GROUP NPI
3	1621984	OTHER	IL	BCBSIL

General Provider Information

NPI Number	:	1053708354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM WELLNESS CENTERS, LLC

Provider Business Mailing Address
First Line	:	1732 W ALGONQUIN RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60192-1573
Country	:	US
Telephone Number	:	630-289-2225
Fax Number	:	630-429-9730

Provider Business Practice Location Address
First Line	:	1732 W ALGONQUIN RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60192-1573
Country	:	US
Telephone Number	:	630-289-2225
Fax Number	:	630-429-9730

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	KARL STEPHEN FORGERON
Credential	:	DC
Telephone Number	:	630-289-2225

Provider Enumeration Date	:	04/24/2015
Last Update Date	:	04/20/2022

Similar Medicare Providers

1477522126 — DR. KARL STEPHEN FORGERON D.C.
Practice Location Address:

1732 W ALGONQUIN RD
HOFFMAN ESTATES, IL
60192-1573

Practice Phone: 630-289-2225
Practice Fax: 630-429-9730

1417022757 — DR. LARS A JOHNSON DDS
Practice Location Address:

1722 W ALGONQUIN RD
HOFFMAN ESTATES, IL
60192-1573

Practice Phone: 847-934-8070
Practice Fax:

1316089378 — DR. WILLIAM A. MOHS DPM
Practice Location Address:

1760 W. ALGONQUIN RD.
HOFFMAN ESTATES, IL
60192-1573

Practice Phone: 847-991-3111
Practice Fax: 847-991-1232

1942474036 — FOREST VIEW PODIATRY CENTER
Practice Location Address:

1760 W ALGONQUIN RD
HOFFMAN ESTATES, IL
60192-1573

Practice Phone: 847-991-3111
Practice Fax:

1235406612 — LARS JOHNSON, DDS, PC
Practice Location Address:

1722 W ALGONQUIN RD
HOFFMAN ESTATES, IL
60192-1573

Practice Phone: 847-934-8070
Practice Fax: 847-934-0930

1245787753 — FREEDOM WELLNESS CENTERS, LLC
Practice Location Address:

1732 W ALGONQUIN RD
HOFFMAN ESTATES, IL
60192-1573

Practice Phone: 630-289-2225
Practice Fax: 630-429-9730

Directions to “FREEDOM WELLNESS CENTERS, LLC ” Practice Location

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