Healthcare Provider Details

I. General information

NPI: 1508677964
Provider Name (Legal Business Name): INTEGRATED WELLNESS CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 N HIGHLAND AVE STE 100
AURORA IL
60506-1459
US

IV. Provider business mailing address

1315 N HIGHLAND AVE STE 100
AURORA IL
60506-1459
US

V. Phone/Fax

Practice location:
  • Phone: 630-413-9119
  • Fax: 312-429-4551
Mailing address:
  • Phone: 630-413-9119
  • Fax: 312-429-4551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ZIA SAMAD
Title or Position: OWNER
Credential:
Phone: 630-873-9215