Provider Demographics
NPI:1871982702
Name:WELLMAN, HILARY (DC)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 W BOUGHTON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1892
Mailing Address - Country:US
Mailing Address - Phone:630-759-8989
Mailing Address - Fax:630-759-8973
Practice Address - Street 1:440 W BOUGHTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1892
Practice Address - Country:US
Practice Address - Phone:630-759-8989
Practice Address - Fax:630-759-8973
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor