| Organization Name: | MIDWEST WELLNESS HEALTH CENTER, LTD |
| NPI Number: | 1053695031 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD A MASUKAWA (PRESIDENT) |
| Mailing Address: | 3202 Northwest Hwy Suite E Cary |
| State: | IL US |
| Postal Code: | 600133507 |
| Phone Number: | 8475307310 |
| Fax Number: | 8476606310 |
| NPI Enumeration Date: | 10/07/2011 |
| NPI Last Update Date: | 10/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036-105621 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |