Healthcare Provider Details

I. General information

NPI: 1760386411
Provider Name (Legal Business Name): SALUS WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

126 PEORIA ST
WASHINGTON IL
61571-2543
US

IV. Provider business mailing address

126 PEORIA ST
WASHINGTON IL
61571-2543
US

V. Phone/Fax

Practice location:
  • Phone: 309-508-7002
  • Fax:
Mailing address:
  • Phone: 309-508-7002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARAH HERRON
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: NP
Phone: 309-508-7002