WELLNESS INTEGRATIVE MEDICINE INC NPI 1114357811

NPI Information

NPI: 1114357811
Provider Name: WELLNESS INTEGRATIVE MEDICINE, INC

Doing Business As: WELLNESS INTEGRATIVE MEDICAL CENTER

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

Specialization: Primary Care

Address:
18036 GOTTSCHALK AVE
HOMEWOOD, IL
ZIP 60430
Phone: (708) 960-2986
Get Directions

WELLNESS INTEGRATIVE MEDICINE, INC is a primary care clinic center in Homewood, IL. WELLNESS INTEGRATIVE MEDICINE, INC NPI is 1114357811. The provider is registered as an organization entity type.
The provider Is Doing Business As Wellness Integrative Medical Center.

The provider's business location address is:

18036 GOTTSCHALK AVE
HOMEWOOD, IL
ZIP 60430-712
Phone: (708) 960-2986
Fax: (855) 869-8599

The provider's authorized official is Rushia Butler .
The authorized official title is Owner and has the following contact phone number (708) 960-2986.

The enumeration date for this NPI number is 11/15/2013 and was last updated on 7/22/2016.

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	036103914	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H18186	MEDICARE UPIN	ILLINOIS

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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »