MEDICARE: TRILLIUM HEALTH & WELLNESS, SC

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

General Provider Information

NPI Number	:	1588615264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRILLIUM HEALTH & WELLNESS, SC

Provider Business Mailing Address
First Line	:	701 E NORTH ST
Second Line	:	STE. B
City	:	ELBURN
State	:	IL
Zip	:	60119-9052
Country	:	US
Telephone Number	:	630-365-5820
Fax Number	:	630-365-5815

Provider Business Practice Location Address
First Line	:	701 E NORTH ST
Second Line	:	STE. B
City	:	ELBURN
State	:	IL
Zip	:	60119-9052
Country	:	US
Telephone Number	:	630-365-5820
Fax Number	:	630-365-5815

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ERIKA K MENNERICK
Credential	:	DC
Telephone Number	:	630-365-5820

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	01/23/2009

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