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General NPI Number Information
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NPI Number | 1629933676
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Entity Type | Organization
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Legal Business Name | ORACLE WELLNESS LLC
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 6723 WEAVER RD STE 127
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City | ROCKFORD
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State | IL
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Zip | 61114-8021
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Country | US
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Telephone | 414-522-8047
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Fax |
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Provider Business Mailing Address
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Address Line | 720 S EASTWOOD DR STE 181
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City | WOODSTOCK
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State | IL
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Zip | 60098-4635
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Country | US
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Telephone | 414-522-8047
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELISHA MAIRET
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Credential | LCSW
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Telephone | 414-522-8047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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