MEDICARE: BEYOND ROOTS WELLNESS PLLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1275480170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND ROOTS WELLNESS PLLC

Provider Business Mailing Address
First Line	:	211 W WACKER DR STE 120-2009
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60606-1217
Country	:	US
Telephone Number	:	630-930-1130
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 W WACKER DR STE 120-2009
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60606-1217
Country	:	US
Telephone Number	:	630-930-1130
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MYLES MCGHEE
Credential	:	LCPC
Telephone Number	:	630-930-1130

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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