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NPI Code Detail

MEDICARE: CHC WELLNESS INC

MEDICARE: CHC WELLNESS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207VX0000XObstetrics Physician
3207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1184785651
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHC WELLNESS INC
Provider Business Mailing Address
First Line : 5440 N. CUMBERLAND AVE
Second Line : SUITE 225
City : CHICAGO
State : IL
Zip : 60656-1531
Country : US
Telephone Number : 847-640-4440
Fax Number : 847-437-2770
Provider Business Practice Location Address
First Line : 5440 N. CUMBERLAND AVE
Second Line : SUITE 225
City : CHICAGO
State : IL
Zip : 60656-1531
Country : US
Telephone Number : 847-640-4440
Fax Number : 847-437-2770
Authorized Official
Title or Position : ACCOUNTING MANAGER
Name : ALINA TRAWICKI
Credential :
Telephone Number : 847-242-3149
Provider Enumeration Date : 12/12/2006
Last Update Date : 04/07/2021

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Directions to “CHC WELLNESS INC ” Practice Location

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