Provider Demographics
NPI:1720714124
Name:OPTIMAL HEALTH & WELLNESS CENTER INC
Entity Type:Organization
Organization Name:OPTIMAL HEALTH & WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KELENYI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-858-9900
Mailing Address - Street 1:800 ROOSEVELT RD STE B101
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5858
Mailing Address - Country:US
Mailing Address - Phone:630-858-9900
Mailing Address - Fax:630-858-9905
Practice Address - Street 1:800 ROOSEVELT RD STE B101
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5858
Practice Address - Country:US
Practice Address - Phone:630-858-9900
Practice Address - Fax:630-858-9905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy