Provider Demographics
NPI:1174791735
Name:ABSOLUTE WELLNESS & REHAB, INC.
Entity type:Organization
Organization Name:ABSOLUTE WELLNESS & REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORNING
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:847-438-0055
Mailing Address - Street 1:720 S RAND RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2467
Mailing Address - Country:US
Mailing Address - Phone:847-438-0055
Mailing Address - Fax:847-438-8649
Practice Address - Street 1:720 S RAND RD
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2467
Practice Address - Country:US
Practice Address - Phone:847-438-0055
Practice Address - Fax:847-438-8649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty