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General NPI Number Information
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NPI Number | 1841945870
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Entity Type | Organization
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Legal Business Name | EVOLVE HEALING AND WELLNESS CENTER
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 579 N 1ST BANK DR STE 150
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City | PALATINE
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State | IL
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Zip | 60067-8102
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Country | US
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Telephone | 312-945-7566
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Fax |
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Provider Business Mailing Address
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Address Line | 579 N 1ST BANK DR STE 150
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City | PALATINE
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State | IL
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Zip | 60067-8102
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Country | US
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Telephone | 312-945-7566
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER/MANAGER
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Name | DR. KARI ALYSSE WEITERSCHAN
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Credential | PHD
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Telephone | 312-945-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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