Provider Demographics
NPI:1588046619
Name:RAM WELLNESS, LLC
Entity type:Organization
Organization Name:RAM WELLNESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATTHES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-208-3243
Mailing Address - Street 1:5514 TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1512
Mailing Address - Country:US
Mailing Address - Phone:312-208-3243
Mailing Address - Fax:
Practice Address - Street 1:5002 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-3659
Practice Address - Country:US
Practice Address - Phone:312-208-3243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty