Healthcare Provider Details

I. General information

NPI: 1780420653
Provider Name (Legal Business Name): WELL WOMENS HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14434 JOHN HUMPHREY DR
ORLAND PARK IL
60462-2638
US

IV. Provider business mailing address

14605 RIDGE AVE
ORLAND PARK IL
60462-1965
US

V. Phone/Fax

Practice location:
  • Phone: 708-671-1264
  • Fax: 630-203-6004
Mailing address:
  • Phone: 708-671-1264
  • Fax: 630-203-6004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ABEER SALHIA RAFATI
Title or Position: PROVIDER
Credential: DNP, FNP-C
Phone: 708-671-1264