Provider Demographics
NPI:1992046494
Name:NATURAL MEDICINE GROUP SC
Entity type:Organization
Organization Name:NATURAL MEDICINE GROUP SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-840-3252
Mailing Address - Street 1:3976 RFD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LONG GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60047-8134
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3976 RFD
Practice Address - Street 2:SUITE D
Practice Address - City:LONG GROVE
Practice Address - State:IL
Practice Address - Zip Code:60047-8134
Practice Address - Country:US
Practice Address - Phone:847-840-3252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012320111N00000X
IL227013647225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty