Healthcare Provider Details

I. General information

NPI: 1982526794
Provider Name (Legal Business Name): NETIV WELLCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2822 W FITCH AVE
CHICAGO IL
60645-2906
US

IV. Provider business mailing address

2822 W FITCH AVE
CHICAGO IL
60645-2906
US

V. Phone/Fax

Practice location:
  • Phone: 630-532-1990
  • Fax:
Mailing address:
  • Phone: 630-532-1990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: NESSA SEXNER
Title or Position: OWNER
Credential:
Phone: 630-532-1990