Healthcare Provider Details

I. General information

NPI: 1194195446
Provider Name (Legal Business Name): CORPORATE WELLNESS PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 07/21/2024
Certification Date: 07/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 S MILWAUKEE AVE
LIBERTYVILLE IL
60048-3225
US

IV. Provider business mailing address

716 S MILWAUKEE AVE
LIBERTYVILLE IL
60048-3225
US

V. Phone/Fax

Practice location:
  • Phone: 847-990-7220
  • Fax:
Mailing address:
  • Phone: 847-990-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BETSY MATTHEWS
Title or Position: CFO
Credential: CPA, MBA
Phone: 847-990-7220