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NPI Code Detail

MEDICARE: WELLBE SENIOR MEDICAL OHIO LLC

MEDICARE: WELLBE SENIOR MEDICAL OHIO LLC
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
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
3207RG0300XGeriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1497308456
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLBE SENIOR MEDICAL OHIO LLC
Provider Business Mailing Address
First Line : 225 W WASHINGTON ST STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60606-3404
Country : US
Telephone Number : 312-776-2422
Fax Number :
Provider Business Practice Location Address
First Line : 6480 ROCKSIDE WOODS BLVD S STE 330
Second Line :
City : INDEPENDENCE
State : OH
Zip : 44131-2222
Country : US
Telephone Number : 312-776-2410
Fax Number :
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. IYAD HOUSHAN
Credential : MD
Telephone Number : 702-236-2929
Provider Enumeration Date : 07/18/2019
Last Update Date : 09/26/2024

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Directions to “WELLBE SENIOR MEDICAL OHIO LLC ” Practice Location

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