MEDICARE: CHRIS SCOTT WELLNESS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	224Y00000X	Clinical Exercise Physiologist
2	225700000X	Massage Therapist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1578956975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRIS SCOTT WELLNESS

Provider Business Mailing Address
First Line	:	1752 WINDSOR RD STE 202
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-4276
Country	:	US
Telephone Number	:	815-977-3747
Fax Number	:

Provider Business Practice Location Address
First Line	:	1752 WINDSOR RD STE 202
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-4276
Country	:	US
Telephone Number	:	815-977-3747
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	SKYLER WHITENACK
Credential	:
Telephone Number	:	815-977-3747

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	05/31/2022

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Directions to “CHRIS SCOTT WELLNESS ” Practice Location

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