Healthcare Provider Details

I. General information

NPI: 1811816986
Provider Name (Legal Business Name): FAITH WELLNESS COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10031 W ROOSEVELT RD STE 210
WESTCHESTER IL
60154-2669
US

IV. Provider business mailing address

10031 W ROOSEVELT RD STE 210
WESTCHESTER IL
60154-2669
US

V. Phone/Fax

Practice location:
  • Phone: 630-290-8735
  • Fax:
Mailing address:
  • Phone:
  • 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: IMAAN AHMED
Title or Position: OWNER & CLINICAL DIRECTOR
Credential:
Phone: 630-290-8735