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General NPI Number Information
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NPI Number | 1346846680
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Entity Type | Organization
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Legal Business Name | DIABETES HEALTH & WELLNESS CENTER, INC
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 103 HIGHWOOD AVE
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City | HIGHWOOD
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State | IL
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Zip | 60040-1546
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Country | US
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Telephone | 734-658-6685
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Fax |
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Provider Business Mailing Address
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Address Line | 34318 N HAVERTON DR
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City | GURNEE
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State | IL
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Zip | 60031-4282
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Country | US
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Telephone | 734-658-6685
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MELISSA MARIE MCGEE
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Credential | DNP, FNP
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Telephone | 734-658-6685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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