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General NPI Number Information
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NPI Number | 1649066895
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Entity Type | Organization
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Legal Business Name | MPOWER WELLNESS LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 7222 W CERMAK RD STE 504
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City | NORTH RIVERSIDE
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State | IL
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Zip | 60546-1443
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Country | US
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Telephone | 773-620-7613
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Fax |
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Provider Business Mailing Address
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Address Line | 3223 LAKE AVE STE 15C
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City | WILMETTE
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State | IL
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Zip | 60091-1069
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Country | US
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Telephone | 847-951-5139
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. JENNIFER ANN PEREZ
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Credential | MD
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Telephone | 847-951-5139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080B0002X
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Taxonomy Name | Pediatric Obesity Medicine Physician
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License Number |
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License Number State |
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