Provider Demographics
NPI:1215569579
Name:ELEVATE WELLNESS LLC
Entity Type:Organization
Organization Name:ELEVATE WELLNESS LLC
Other - Org Name:ELEVATE WELLNESS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MOURICE
Authorized Official - Last Name:MSEIH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-213-0224
Mailing Address - Street 1:6708 N CRAWFORD AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3508
Mailing Address - Country:US
Mailing Address - Phone:847-213-0224
Mailing Address - Fax:312-488-2551
Practice Address - Street 1:4001 W DEVON AVE STE 406
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4539
Practice Address - Country:US
Practice Address - Phone:847-213-0224
Practice Address - Fax:312-488-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty