| Organization Name: | ADVANCED WELLNESS MEDICAL, LLC |
| NPI Number: | 1831597194 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMMY WANG (OWNER/D.C) |
| Mailing Address: | 6325 Main Street Suite 120 Woodridge |
| State: | IL US |
| Postal Code: | 60517 |
| Phone Number: | 6305416773 |
| Fax Number: | |
| NPI Enumeration Date: | 12/18/2014 |
| NPI Last Update Date: | 04/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |