Healthcare Provider Details

I. General information

NPI: 1750154027
Provider Name (Legal Business Name): BARTLETT HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W BARTLETT AVE
BARTLETT IL
60103-4002
US

IV. Provider business mailing address

300 W BARTLETT AVE
BARTLETT IL
60103-4002
US

V. Phone/Fax

Practice location:
  • Phone: 224-633-8447
  • Fax:
Mailing address:
  • Phone: 224-633-8447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAHREN KHOSHABA
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 224-633-8447