Healthcare Provider Details

I. General information

NPI: 1861312944
Provider Name (Legal Business Name): ATLAS WELLNESS HOLDINGS LLC - ATLAS INTEGRATED HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N IL ROUTE 31
CRYSTAL LAKE IL
60012-3716
US

IV. Provider business mailing address

600 N IL ROUTE 31
CRYSTAL LAKE IL
60012-3716
US

V. Phone/Fax

Practice location:
  • Phone: 815-560-2163
  • Fax:
Mailing address:
  • Phone: 815-560-2163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. ANGELA M BYRNES
Title or Position: OWNER
Credential: APRN
Phone: 815-560-2163