Provider Demographics
NPI:1992037600
Name:6 ESSENTIALS INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:6 ESSENTIALS INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLODKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CPT
Authorized Official - Phone:708-846-6993
Mailing Address - Street 1:11267 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-4416
Mailing Address - Country:US
Mailing Address - Phone:708-846-6993
Mailing Address - Fax:
Practice Address - Street 1:11267 W 159TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-4416
Practice Address - Country:US
Practice Address - Phone:708-846-6993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty