Healthcare Provider Details

I. General information

NPI: 1023998754
Provider Name (Legal Business Name): FMH WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29W170 BUTTERFIELD RD STE 101 AND 102
WARRENVILLE IL
60555
US

IV. Provider business mailing address

29W170 BUTTERFIELD RD STE 101
WARRENVILLE IL
60555-2808
US

V. Phone/Fax

Practice location:
  • Phone: 224-267-5569
  • Fax:
Mailing address:
  • Phone: 224-267-5569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIYAH HUSSAIN
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 224-267-5569