Provider Demographics
NPI:1447509864
Name:CORE WELLNESS CHIROPRACTIC AND ANTI-AGING CENTRE
Entity type:Organization
Organization Name:CORE WELLNESS CHIROPRACTIC AND ANTI-AGING CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ZANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-208-1110
Mailing Address - Street 1:21 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2224
Mailing Address - Country:US
Mailing Address - Phone:630-208-1110
Mailing Address - Fax:
Practice Address - Street 1:21 N 2ND ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2224
Practice Address - Country:US
Practice Address - Phone:630-208-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty