OrganizationActive
Exercising Nutritionally, LLC
NPI 1629417357 · Research Clinic/Center · Lisle, IL
Provider details
- NPI number
- 1629417357
- Entity type
- Organization
- Primary specialty
- Research Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Craig Broeder, Ceo/Founder(630) 303-3686
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
4225 Naperville Rd
Enllc Located Within Lifestart Fitness Center
Lisle, IL 60532-3656
Phone: (630) 303-3686
Approximate (ZIP-level) locationGet directions
Mailing address
1943 Phaeton Ct
Naperville, IL 60565-2410
Registry dates
- Enumerated
- 2013-06-15
- Last updated
- 2013-06-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.