EXERCISING NUTRITIONALLY, LLC (NPI# 1629417357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629417357 |
| Entity Type | Organization |
| Organization Name | EXERCISING NUTRITIONALLY, LLC |
| Practice Address |
4225 Naperville Rd Enllc Located Within Lifestart Fitness Center Lisle IL 60532-3656 |
| Mailing Address |
1943 Phaeton Ct Naperville IL 60565-2410 |
| Practice Telephone | 6303033686 |
| Mailing Telephone | 6303033686 |
| Enumeration Date | 2013-06-15 |
| Last Update Date | 2013-06-15 |
| Authorized Official Name | DR. CRAIG E BROEDER (CEO/FOUNDER) |
| Authorized Official Telephone | 6303033686 |
| Authorized Official Credential | PH.D. FACSM, FNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1100X |
Clinic/Center Specialization: Research |
Ambulatory Health Care Facilities |
| Street Address |
4225 NAPERVILLE RD ENLLC LOCATED WITHIN LIFESTART FITNESS CENTER |
| City | LISLE |
| State | IL |
| Zip Code | 60532-3656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326675760 | Contemporary Wellness, LLC | Counselor | 4300 Commerce Court, Suite 300-9, Lisle, IL 60532 | 2020-03-25 |
| 1841825510 | Ih Lisle Opco, LLC | Skilled Nursing Facility | 2850 Ogden Avenue, Lisle, IL 60532 | 2020-03-03 |
| 1598305849 | Peter Sismour | Counselor | 4603 Main Street, Lisle, IL 60532 | 2020-01-14 |
| 1336634856 | Forward Emotion, LLC | Counselor | 3060 Ogden Ave Ste 102, Lisle, IL 60532 | 2018-06-27 |
| 1801397179 | David Rodemaker | Psychologist | 1500 Eisenhower Lane, Suite 300, Lisle, IL 60532 | 2018-02-22 |
| 1801325139 | Naperville Psychological Associates LLC | Psychologist | 6010 S Route 59, Suite B, Lisle, IL 60532 | 2017-06-09 |
| 1831649730 | Paige Diesner | Physician Assistant | 430 Warrenville Rd., Ste 300, Lisle, IL 60532 | 2016-10-04 |
| 1174978860 | Lisa Schaedler | Social Worker | 4774 Hill Trail Rd Apt 2c, Lisle, IL 60532 | 2016-04-29 |
| 1831578962 | Farah Budd | Occupational Therapist | 748 Riedy Rd, Lisle, IL 60532 | 2015-05-21 |
| 1649602822 | Marie Ann Markham Gonzalez | Developmental Therapist | 5629 Dover Dr, Lisle, IL 60532 | 2013-07-30 |
| Find all providers in zip 60532 | ||||
| Taxonomy Code | 261QR1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Research |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891270559 | Affinity Health Corp. | Clinic/Center | 2425 W 22nd St Ste 209, Oak Brook, IL 60523-4655 | 2018-09-28 |
| 1730679846 | Beshoy Benyamen | Clinic/Center | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2018-05-14 |
| 1366953101 | Health Elements Integrative Medical Institute | Clinic/Center | 19740 Governors Hwy Ste 117, Flossmoor, IL 60422-2085 | 2017-10-19 |
| 1972984052 | Swia, LLC | Clinic/Center | 2010 Jacobssen Dr, Normal, IL 61761-6280 | 2015-06-15 |
| 1194032565 | Health Research Institute Inc. | Clinic/Center | 4575 Weaver Pkwy, Warrenville, IL 60555-4039 | 2010-09-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.