PROSPER HEALTH AND WELLNESS LLC NPI 1619572419

NPI Information

NPI: 1619572419
Provider Name: PROSPER HEALTH AND WELLNESS, LLC

Doing Business As: PROSPER HEALTH AND WELLNESS

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
7901 W 159TH ST
TINLEY PARK, IL
ZIP 60477
Phone: (312) 279-9814
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PROSPER HEALTH AND WELLNESS, LLC is a primary care clinic center in Tinley Park, IL. PROSPER HEALTH AND WELLNESS, LLC NPI is 1619572419. The provider is registered as an organization entity type.
The provider Is Doing Business As Prosper Health And Wellness.

The provider's business location address is:

7901 W 159TH ST
TINLEY PARK, IL
ZIP 60477-881
Phone: (312) 279-9814
Fax: (312) 279-9879

The provider's authorized official is Gladys Larsen .
The authorized official title is Founder-ceo and has the following contact phone number (312) 279-9184.

The CLIA number assigned to this NPI record is 14D2284962 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/1/2020 and was last updated on 6/14/2023.

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	261QP2300X	Clinic/Center	Primary Care			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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