Healthcare Provider Details

I. General information

NPI: 1801762885
Provider Name (Legal Business Name): WE ARE OF GOD MININSTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 W TOUHY AVE
CHICAGO IL
60645-3008
US

IV. Provider business mailing address

2716 W TOUHY AVE
CHICAGO IL
60645-3008
US

V. Phone/Fax

Practice location:
  • Phone: 773-739-7926
  • Fax:
Mailing address:
  • Phone: 773-739-7926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: PAULETTE FOWLER
Title or Position: EXCUTIVE DIRECTOR
Credential: EXCUTIVE
Phone: 773-739-7926