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COMMUNITY WELLNESS GROUP LLC NPI 1144820648


NPI Information

NPI: 1144820648
Provider Name: COMMUNITY WELLNESS GROUP LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
635 ARGYLE AVE
FLOSSMOOR, IL
ZIP 60422
Phone: (773) 844-8813
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COMMUNITY WELLNESS GROUP LLC is a mental health (including community mental health center) clinic center in Flossmoor, IL. COMMUNITY WELLNESS GROUP LLC NPI is 1144820648. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

635 ARGYLE AVE
FLOSSMOOR, IL
ZIP 60422-201
Phone: (773) 844-8813

The provider's authorized official is Shirlyn Maria Garrett-wilson .
The authorized official title is Vice President Of Clinical Services and has the following contact phone number (773) 320-9592.

The enumeration date for this NPI number is 10/26/2020 and was last updated on 5/4/2022.


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
1101YM0800XCounselorMental HealthNo
21041C0700XSocial WorkerClinicalNo
3251S00000XCommunity/Behavioral HealthNo
4261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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
119002MEDICAIDILLINOIS

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

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