Healthcare Provider Details
I. General information
NPI: 1811789522
Provider Name (Legal Business Name): PYRAMID HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 N FARNSWORTH AVE
AURORA IL
60505-3008
US
IV. Provider business mailing address
317 N FARNSWORTH AVE
AURORA IL
60505-3008
US
V. Phone/Fax
- Phone: 630-977-6877
- Fax:
- Phone: 630-977-6877
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DONALD
ADESHINA
WALKER
Title or Position: MD
Credential:
Phone: 630-977-6877