Provider Demographics
NPI:1780835017
Name:SAGE HEALING COLLECTIVE S.C.
Entity Type:Organization
Organization Name:SAGE HEALING COLLECTIVE S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-204-9742
Mailing Address - Street 1:525 TYLER RD STE S
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-3363
Mailing Address - Country:US
Mailing Address - Phone:319-015-6723
Mailing Address - Fax:
Practice Address - Street 1:525 TYLER RD STE S
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-3363
Practice Address - Country:US
Practice Address - Phone:331-901-5672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2233942OtherBCBS