Provider Demographics
NPI:1811133499
Name:REMEDY, LLC
Entity type:Organization
Organization Name:REMEDY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAHOLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-324-6019
Mailing Address - Street 1:1245 S MICHIGAN AVE # 124
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2408
Mailing Address - Country:US
Mailing Address - Phone:630-324-6019
Mailing Address - Fax:
Practice Address - Street 1:1245 S MICHIGAN AVE # 124
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2408
Practice Address - Country:US
Practice Address - Phone:630-324-6019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011307111N00000X
IL227005393225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty