Provider Demographics
NPI:1699193342
Name:GOLD NAPRAPATHIC & WELLNESS CENTER, PC
Entity Type:Organization
Organization Name:GOLD NAPRAPATHIC & WELLNESS CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NAPRAPATH
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DN
Authorized Official - Phone:773-443-3132
Mailing Address - Street 1:4305 N LINCOLN AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-1711
Mailing Address - Country:US
Mailing Address - Phone:773-443-3132
Mailing Address - Fax:
Practice Address - Street 1:4305 N LINCOLN AVE
Practice Address - Street 2:SUITE F
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1711
Practice Address - Country:US
Practice Address - Phone:773-443-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181000333172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172P00000XOther Service ProvidersNaprapathGroup - Single Specialty