| Organization Name: | MENS HEALTH CHICAGO LLC |
| NPI Number: | 1104111848 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JR WADE (MEMBER) |
| Mailing Address: | 1396 Newcastle Ct Bartlett |
| State: | IL US |
| Postal Code: | 601032989 |
| Phone Number: | 4802292013 |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2011 |
| NPI Last Update Date: | 06/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | AP3397 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |