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General NPI Number Information
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NPI Number | 1861281925
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Entity Type | Organization
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Legal Business Name | LIVINGWELL CLINIC PLLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 473 W ARMY TRAIL RD STE 105
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2674
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Country | US
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Telephone | 630-242-2455
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Fax |
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Provider Business Mailing Address
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Address Line | 473 W ARMY TRAIL RD STE 105
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2674
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Country | US
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Telephone | 630-242-2455
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Fax |
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Authorized Official
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Title or Position | MD/OWNER
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Name | MANALI PATEL
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Credential | MD
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Telephone | 630-242-2455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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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 | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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