Healthcare Provider Details

I. General information

NPI: 1750294955
Provider Name (Legal Business Name): WE THRIVE WELLNESS CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S WOLF RD APT 320
HILLSIDE IL
60162-2125
US

IV. Provider business mailing address

2121 S WOLF RD APT 320
HILLSIDE IL
60162-2125
US

V. Phone/Fax

Practice location:
  • Phone: 630-426-9365
  • Fax:
Mailing address:
  • Phone: 630-426-9365
  • 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 StateNULL

VIII. Authorized Official

Name: LATRIONNA MOORE
Title or Position: MANAGER
Credential: LCSW
Phone: 630-426-9365