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General NPI Number Information
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NPI Number | 1801571229
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Entity Type | Organization
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Legal Business Name | HEARTLAND WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 18036 GOTTSCHALK AVE
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City | HOMEWOOD
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State | IL
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Zip | 60430-1712
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Country | US
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Telephone | 708-491-2655
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Fax |
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Provider Business Mailing Address
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Address Line | 304 QUEENS LN
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City | THORNTON
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State | IL
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Zip | 60476-1080
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Country | US
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Telephone | 708-564-5071
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Fax | 708-564-5010
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Authorized Official
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Title or Position | APN
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Name | TALETHA K BROWN
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Credential | APN
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Telephone | 708-491-2655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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