Provider Demographics
NPI:1295006336
Name:A BETTER WEIGH
Entity Type:Organization
Organization Name:A BETTER WEIGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHANAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-496-4222
Mailing Address - Street 1:200 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 607
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5909
Mailing Address - Country:US
Mailing Address - Phone:312-957-7988
Mailing Address - Fax:
Practice Address - Street 1:200 N MICHIGAN AVE
Practice Address - Street 2:SUITE 607
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5909
Practice Address - Country:US
Practice Address - Phone:312-957-7988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.003736261QC1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health