Provider Demographics
NPI:1023379294
Name:WHITE EAGLE HEALTH AND WELLNESS INC.
Entity Type:Organization
Organization Name:WHITE EAGLE HEALTH AND WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETRZYK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:331-457-5671
Mailing Address - Street 1:1276 E CHICAGO AVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5639
Mailing Address - Country:US
Mailing Address - Phone:331-457-5671
Mailing Address - Fax:331-457-5985
Practice Address - Street 1:1276 E CHICAGO AVE
Practice Address - Street 2:SUITE #100
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5639
Practice Address - Country:US
Practice Address - Phone:331-457-5671
Practice Address - Fax:331-457-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty