Healthcare Provider Details

I. General information

NPI: 1710724497
Provider Name (Legal Business Name): GROW WELLNESS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 5TH AVE STE 108
NAPERVILLE IL
60563-3173
US

IV. Provider business mailing address

200 E 5TH AVE STE 108
NAPERVILLE IL
60563-3173
US

V. Phone/Fax

Practice location:
  • Phone: 224-357-6296
  • Fax:
Mailing address:
  • Phone: 224-357-6296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: WENDY HAYUM GROSS
Title or Position: PRESIDENT
Credential: LCPC
Phone: 630-601-4120