MEDICARE: TRCWELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1104775030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRCWELLNESS

Provider Business Mailing Address
First Line	:	1105 W CHICAGO AVE STE 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5771
Country	:	US
Telephone Number	:	312-610-3708
Fax Number	:

Provider Business Practice Location Address
First Line	:	1105 W CHICAGO AVE STE 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5771
Country	:	US
Telephone Number	:	312-610-3708
Fax Number	:

Authorized Official
Title or Position	:	CHIEF PROGRAM OFFICE
Name	:	DR. SHERILYNN ASUOHA
Credential	:	LCPC
Telephone Number	:	312-610-3708

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	03/20/2026

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Directions to “TRCWELLNESS ” Practice Location

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