Provider Demographics
NPI:1063743342
Name:CORE1, INC
Entity type:Organization
Organization Name:CORE1, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WNEK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:630-973-8626
Mailing Address - Street 1:25244 PASTORAL DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-1340
Mailing Address - Country:US
Mailing Address - Phone:630-973-8626
Mailing Address - Fax:
Practice Address - Street 1:1426 BROOK DR
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1025
Practice Address - Country:US
Practice Address - Phone:630-973-8626
Practice Address - Fax:800-409-4879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty