EBONY WELLNESS LLC NPI 1003574757

NPI Information

NPI: 1003574757
Provider Name: EBONY WELLNESS LLC
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Organization

Specialization: Gerontology

Address:
7531 S STONY ISLAND AVE STE 164
CHICAGO, IL
ZIP 60649
Phone: (773) 947-7689
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EBONY WELLNESS LLC is a gerontology nurse practitioner in Chicago, IL. EBONY WELLNESS LLC NPI is 1003574757. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7531 S STONY ISLAND AVE STE 164
CHICAGO, IL
ZIP 60649-954
Phone: (773) 947-7689
Fax: (773) 947-7338

The provider's authorized official is Tammy Dobbin .
The authorized official title is Owner and has the following contact phone number (773) 960-3276.

The enumeration date for this NPI number is 11/30/2021 and was last updated on 11/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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