Provider Demographics
NPI:1720636996
Name:MINX WELLNESS, PC
Entity Type:Organization
Organization Name:MINX WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-502-2538
Mailing Address - Street 1:2057 GREEN BAY RD STE A
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-6101
Mailing Address - Country:US
Mailing Address - Phone:224-707-0572
Mailing Address - Fax:
Practice Address - Street 1:2057 GREEN BAY RD STE A
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-6101
Practice Address - Country:US
Practice Address - Phone:224-707-0572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty