Provider Demographics
NPI:1760062277
Name:RIES WELLNESS PLLC
Entity Type:Organization
Organization Name:RIES WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-636-3786
Mailing Address - Street 1:2125 N DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-9613
Mailing Address - Country:US
Mailing Address - Phone:312-636-3786
Mailing Address - Fax:
Practice Address - Street 1:2125 N DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-9613
Practice Address - Country:US
Practice Address - Phone:312-636-3786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1184060295OtherNPI