NPI 1023495421

Pain and Wellness Group 2 LTD

Organisation General Practice Physician Villa Park, IL

Practice location

Address: 411 W Saint Charles Rd, Villa Park, IL 60181-2432
Phone: (630) 691-1234
Mailing address: PO Box 9, Batavia, IL 60510-0009

Authorised official

Name: Luke Lotriet
Title: Owner
Phone: (630) 691-1234

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 036107014 (IL)

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Registry record

NPI: 1023495421
Entity type: Organization
NPI issued: 5 May 2015
Record last updated: 24 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.