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General NPI Number Information
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NPI Number | 1417642752
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Entity Type | Organization
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Legal Business Name | RAY OF HOPE HEALTH AND WELLNESS SERVICES
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 2901 CHICAGO RD
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City | SOUTH CHICAGO HEIGHTS
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State | IL
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Zip | 60411-5536
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Country | US
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Telephone | 708-755-5701
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 CHICAGO RD
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City | SOUTH CHICAGO HEIGHTS
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State | IL
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Zip | 60411-5536
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AISHA WESLEY
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Credential |
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Telephone | 708-755-5701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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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