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NPI Code Detail

MEDICARE: ZALWANGO HEALTH& WELLNESS CONCIERGE PC

MEDICARE: ZALWANGO HEALTH& WELLNESS CONCIERGE PC
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
1363L00000XNurse Practitioner

General Provider Information

NPI Number : 1962772996
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZALWANGO HEALTH& WELLNESS CONCIERGE PC
Provider Business Mailing Address
First Line : 8610 PRAIRIE ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-2282
Country : US
Telephone Number : 872-600-5700
Fax Number :
Provider Business Practice Location Address
First Line : 5250 OLD ORCHARD RD STE 300
Second Line :
City : SKOKIE
State : IL
Zip : 60077-4462
Country : US
Telephone Number : 877-506-9955
Fax Number : 855-734-3355
Authorized Official
Title or Position : PRESIDENT AND SECRETARY
Name : DR. MADTURA ZALWANGO
Credential : NP
Telephone Number : 312-217-4671
Provider Enumeration Date : 01/06/2012
Last Update Date : 10/02/2021

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Directions to “ZALWANGO HEALTH& WELLNESS CONCIERGE PC ” Practice Location

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