| Active Wd Inn Llc | |
|
754 S 8th St West Dundee IL 60118-2102 | |
| (847) 836-5202 | |
| Not Available |
| Full Name | Active Wd Inn Llc |
|---|---|
| Speciality | General Practice |
| Location | 754 S 8th St, West Dundee, Illinois |
| Authorized Official Name and Position | Masood Majeed (DC) |
| Authorized Official Contact | 8478365202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Wd Inn Llc 754 S 8th St West Dundee IL 60118-2102 Ph: (847) 836-5202 | Active Wd Inn Llc 754 S 8th St West Dundee IL 60118-2102 Ph: (847) 836-5202 |
| NPI Number | 1710699616 |
|---|---|
| Provider Enumeration Date | 12/22/2022 |
| Last Update Date | 08/31/2023 |
| Medicare PECOS PAC ID | 3375915440 |
|---|---|
| Medicare Enrollment ID | O20230218000487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710699616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | James R Otoole |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1952746794 PECOS PAC ID: 6507005832 Enrollment ID: I20130618000536 |
| Provider Name | Charles J Meehleib |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811368061 PECOS PAC ID: 1355651290 Enrollment ID: I20151105001738 |
| Provider Name | Masood I Majeed |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1932599016 PECOS PAC ID: 7012211964 Enrollment ID: I20160212001313 |
| Provider Name | Anne Marie Lodewyck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891463220 PECOS PAC ID: 1456745116 Enrollment ID: I20220223002892 |
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