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General NPI Number Information
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NPI Number | 1992604714
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Entity Type | Organization
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Legal Business Name | THRIVE WELLNESS CLINIC
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 804 DONELSON COURT
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City | NAPERVILLE
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State | IL
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Zip | 60563-4758
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Country | US
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Telephone | 630-768-4048
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Fax |
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Provider Business Mailing Address
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Address Line | 804 DONELSON COURT
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City | NAPERVILLE
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State | IL
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Zip | 60563-4758
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Country | US
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Telephone | 630-768-4048
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | MRS. SUMATHI JEGANNATHAN
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Credential | FPA-APRN
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Telephone | 630-768-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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