MEDICARE: WELL WITH MY SOUL HOLISTIC HEALTH CENTER LLC- HEART TO HEART THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208100000X	Physical Medicine & Rehabilitation Physician
2	133NN1002X	Nutrition Education Nutritionist
3	171400000X	Health & Wellness Coach
4	225700000X	Massage Therapist
5	171M00000X	Case Manager/Care Coordinator
6	172P00000X	Naprapath
7	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1801750153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL WITH MY SOUL HOLISTIC HEALTH CENTER LLC- HEART TO HEART THERAPY LLC

Provider Business Mailing Address
First Line	:	8149 S BLACKSTONE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60619-4616
Country	:	US
Telephone Number	:	773-978-6145
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 W ADDISON ST STE 303
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-4468
Country	:	US
Telephone Number	:	773-978-6145
Fax Number	:	773-913-1792

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	DR. SOONITI JEANETTE WEEMS
Credential	:
Telephone Number	:	773-978-6145

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	03/04/2026

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