Provider Demographics
NPI:1922573567
Name:TRUE BLUE HEALTH & WELLNESS
Entity Type:Organization
Organization Name:TRUE BLUE HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-951-6085
Mailing Address - Street 1:509 W OLD NORTHWEST HWY STE 100C
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:509 W OLD NORTHWEST HWY STE 100C
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6816
Practice Address - Country:US
Practice Address - Phone:224-655-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics