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General NPI Number Information
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NPI Number | 1548155765
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Entity Type | Organization
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Legal Business Name | SERAPHIC FAMILY CARE AND WELLNESS LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 21660 W FIELD PKWY
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City | DEER PARK
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State | IL
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Zip | 60010-7265
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Country | US
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Telephone | 847-900-8796
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Fax |
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Provider Business Mailing Address
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Address Line | 21660 W FIELD PKWY
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City | DEER PARK
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State | IL
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Zip | 60010-7265
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Country | US
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Telephone | 847-900-8796
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SERAPHIN BAMOUNI
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Credential | NURSE PRACTICTIONER
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Telephone | 206-409-0256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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