MEDICARE: BAAL PERAZIM 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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1194675942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAAL PERAZIM WELLNESS, INC

Provider Business Mailing Address
First Line	:	1823 W 47TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-3843
Country	:	US
Telephone Number	:	773-665-0275
Fax Number	:

Provider Business Practice Location Address
First Line	:	1823 W 47TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-3843
Country	:	US
Telephone Number	:	773-665-0275
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MAURICE BROWNLEE
Credential	:
Telephone Number	:	773-296-2400

Provider Enumeration Date	:	01/31/2026
Last Update Date	:	01/31/2026

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Directions to “BAAL PERAZIM WELLNESS, INC ” Practice Location

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