Provider Demographics
NPI:1255695516
Name:EASE WELLNESS LLC
Entity type:Organization
Organization Name:EASE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-935-9273
Mailing Address - Street 1:1437 W MONTROSE AVE
Mailing Address - Street 2:A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1348
Mailing Address - Country:US
Mailing Address - Phone:773-935-3273
Mailing Address - Fax:773-935-6022
Practice Address - Street 1:1437 W MONTROSE AVE
Practice Address - Street 2:A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1348
Practice Address - Country:US
Practice Address - Phone:773-935-3273
Practice Address - Fax:773-935-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-01
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03800648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty