Provider Demographics
NPI:1629397310
Name:UNIVERSAL PAIN AND WELLNESS PC
Entity Type:Organization
Organization Name:UNIVERSAL PAIN AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:ECKELBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-543-1929
Mailing Address - Street 1:601 W ARMY TRAIL BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3299
Mailing Address - Country:US
Mailing Address - Phone:630-543-1929
Mailing Address - Fax:630-543-1931
Practice Address - Street 1:601 W ARMY TRAIL BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-3299
Practice Address - Country:US
Practice Address - Phone:630-543-1929
Practice Address - Fax:630-543-1931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011060111N00000X
IL070016639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty