Provider Demographics
NPI:1245480367
Name:NEXT LEVEL HEALTH,LLC
Entity type:Organization
Organization Name:NEXT LEVEL HEALTH,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMETT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BLAHNIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-708-6195
Mailing Address - Street 1:2835 MCFARLAND RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6819
Mailing Address - Country:US
Mailing Address - Phone:815-708-6195
Mailing Address - Fax:
Practice Address - Street 1:2835 MCFARLAND RD
Practice Address - Street 2:SUITE D
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6819
Practice Address - Country:US
Practice Address - Phone:815-708-6195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4247012111N00000X
IL038-011886111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000015023OtherMEDICARE PTAN
WI000015023OtherMEDICARE PTAN