Healthcare Provider Details

I. General information

NPI: 1760236004
Provider Name (Legal Business Name): PURE WELLNESS CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6853 KINGERY HWY
WILLOWBROOK IL
60527-5114
US

IV. Provider business mailing address

5048 PRAIRIE SAGE LN
NAPERVILLE IL
60564-4321
US

V. Phone/Fax

Practice location:
  • Phone: 630-387-6577
  • Fax: 630-387-6854
Mailing address:
  • Phone: 708-745-0832
  • Fax: 630-387-6854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YULIYA L RASHEVSKA
Title or Position: APRN
Credential:
Phone: 630-387-6577