WILLOW WELLNESS CENTER LLC NPI 1154437739

NPI Information

NPI: 1154437739
Provider Name: WILLOW WELLNESS CENTER, LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
1400 RENAISSANCE DR STE 401
PARK RIDGE, IL
ZIP 60068
Phone: (847) 318-8200
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WILLOW WELLNESS CENTER, LLC is an adult mental health clinic center in Park Ridge, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. WILLOW WELLNESS CENTER, LLC NPI is 1154437739. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1400 RENAISSANCE DR STE 401
PARK RIDGE, IL
ZIP 60068-337
Phone: (847) 318-8200
Fax: (847) 318-9170

The provider's authorized official is Lisa Cecilia Campbell .
The authorized official title is Co-director and has the following contact phone number (847) 318-8200.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 1/26/2023.

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	103TC0700X	Psychologist	Clinical			No
2	261QM0850X	Clinic/Center	Adult Mental Health			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: 5/5/2024

NPI Synchronization or Removal

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