Provider Demographics
NPI:1457866410
Name:NEW DAY WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:NEW DAY WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DYBALA
Authorized Official - Suffix:
Authorized Official - Credentials:ND, DC
Authorized Official - Phone:630-344-9693
Mailing Address - Street 1:600 S COUNTY FARM RD STE 204
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4575
Mailing Address - Country:US
Mailing Address - Phone:630-344-9693
Mailing Address - Fax:630-791-3759
Practice Address - Street 1:600 S COUNTY FARM RD STE 204
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4575
Practice Address - Country:US
Practice Address - Phone:630-344-9693
Practice Address - Fax:630-791-3759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILD38-012305261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center