Provider Demographics
NPI:1568866523
Name:ANTALEE WELLNESS CENTER
Entity Type:Organization
Organization Name:ANTALEE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUTCHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ND
Authorized Official - Phone:847-486-1130
Mailing Address - Street 1:1834 GLENVIEW RD
Mailing Address - Street 2:2M
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-6921
Mailing Address - Country:US
Mailing Address - Phone:184-748-6113
Mailing Address - Fax:
Practice Address - Street 1:1834 GLENVIEW RD
Practice Address - Street 2:2M
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-6921
Practice Address - Country:US
Practice Address - Phone:184-748-6113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health