| Organization Name: | PROGRESSIVE CHIROPRACTIC WELLNESS & REHAB CENTRE, P.C. |
| NPI Number: | 1023206265 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AARON WOODYATT (OWNER) |
| Mailing Address: | 6270 E Riverside Blvd Loves Park |
| State: | IL US |
| Postal Code: | 611114418 |
| Phone Number: | 8156362225 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2007 |
| NPI Last Update Date: | 10/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 305S00000X |
| License Number: | 038009629 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Point of Service |
| Taxonomy Specialization: | |
| Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |