Healthcare Provider Details

I. General information

NPI: 1790654713
Provider Name (Legal Business Name): INTEGRATIVE PATHWAYS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 WESTMORE MEYERS RD STE A10
LOMBARD IL
60148-3777
US

IV. Provider business mailing address

837 WESTMORE MEYERS RD STE A10
LOMBARD IL
60148-3777
US

V. Phone/Fax

Practice location:
  • Phone: 815-782-8440
  • Fax: 815-926-5305
Mailing address:
  • Phone: 815-782-8440
  • Fax: 815-926-5305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CHAVEZ
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 210-897-1770