Provider Type Icon

ADVANCED WELLNESS MEDICAL LLC NPI 1831597194


NPI Information

NPI: 1831597194
Provider Name: ADVANCED WELLNESS MEDICAL, LLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 14D0989623

Address:
6325 MAIN STREET
SUITE 120
WOODRIDGE, IL
ZIP 60517
Phone: (630) 541-6773
Get Directions

ADVANCED WELLNESS MEDICAL, LLC is a general practice in Woodridge, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee ADVANCED WELLNESS MEDICAL, LLC NPI is 1831597194. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6325 MAIN STREET
SUITE 120
WOODRIDGE, IL
ZIP 60517
Phone: (630) 541-6773

The provider's authorized official is Emmy Wang .
The authorized official title is Owner/d.c and has the following contact phone number (630) 542-2598.

The CLIA number assigned to this NPI record is 14D0989623 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 12/18/2014 and was last updated on 4/2/2015.


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
1208D00000XGeneral PracticeILLINOISYes

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

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.