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General NPI Number Information
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NPI Number | 1740147669
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Entity Type | Organization
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Legal Business Name | WELLNESS PRIMARY CARE
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 975 S DURKIN DR
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City | SPRINGFIELD
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State | IL
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Zip | 62704-1386
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Country | US
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Telephone | 773-316-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 403 PIAZZA LN
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City | CHATHAM
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State | IL
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Zip | 62629-5035
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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/PHYSICIAN
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Name | ALICIA ALTHEIMER
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Credential | MD
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Telephone | 773-316-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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