TWO ROADS WELLNESS CLINIC LLC NPI 1417329426

NPI Information

  • NPI: 1417329426
  • Provider Name: TWO ROADS WELLNESS CLINIC, LLC
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: TWO ROADS WELLNESS CLINIC
  • CLIA Number: 14D2187374
  • Address: 3545 N VERMILION ST
    DANVILLE, IL
    ZIP 61832
  • Phone: (217) 651-6801

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NPI Details

TWO ROADS WELLNESS CLINIC, LLC is a primary care nurse practitioner in Danville, IL. TWO ROADS WELLNESS CLINIC, LLC NPI is 1417329426. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Two Roads Wellness Clinic.

The provider's business location address is:

3545 N VERMILION ST
DANVILLE, IL
ZIP 61832-100
Phone: (217) 651-6801
Fax: (217) 651-6802

The provider's authorized official is Jessica Nemecz .
The authorized official title is Counselor and has the following contact phone number (217) 651-6801.

The CLIA number assigned to this NPI record is 14D2187374 - other - aprns with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/29/2015 and was last updated on 12/13/2024.

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
1101Y00000XCounselorNo
2251S00000XCommunity/Behavioral HealthNo
3261QP2000XClinic/CenterPhysical TherapyNo
4363L00000XNurse PractitionerNo
5363LP2300XNurse PractitionerPrimary CareYes

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: 11/21/2025

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