PURE ABUNDANT WELLNESS CENTER (NPI# 1932564481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932564481 |
Entity Type | Organization |
Organization Name | PURE ABUNDANT WELLNESS CENTER |
Practice Address |
20200 Governors Dr Suite 107 Olympia Fields IL 60461-1032 |
Practice Telephone | 7085601235 |
Mailing Telephone | 7085601235 |
Enumeration Date | 2015-12-29 |
Last Update Date | 2015-12-29 |
Authorized Official Name | LISA WALLACE (CEO) |
Authorized Official Telephone | 7085601235 |
Authorized Official Credential | EDD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
180.008731 | IL | Behavioral Health & Social Service Providers |
Street Address |
20200 GOVERNORS DR SUITE 107 |
City | OLYMPIA FIELDS |
State | IL |
Zip Code | 60461-1032 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730334764 | Neighborhood Pedicatrics Sc | Pediatrics | 20200 Governors Dr, 101, Olympia Fields, IL 60461-1032 | 2008-11-18 |
1427463405 | Lisa Wallace | Counselor | 20200 Governors Dr, 107, Olympia Fields, IL 60461-1032 | 2014-06-27 |
1619300605 | Lisa Wallace | Counselor | 20200 Governors Dr, 107, Olympia Fields, IL 60461-1032 | 2013-08-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609372564 | Katherine Gill Haddad | Student in an Organized Health Care Education/Training Program | 20201 S. Crawford Avenue, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2018-03-31 |
1750886610 | Kim Minh Dang | Student in an Organized Health Care Education/Training Program | 20201 South Crawford, Olympia Fields, IL 60461 | 2018-03-23 |
1619484110 | Alexandra N. Douvas | Dentist | 20180 Governors Hwy, Ste 104, Olympia Fields, IL 60461 | 2018-01-05 |
1992258438 | Krystyne Doty | Nurse Practitioner | 3800 W 203rd St Ste 209, Olympia Fields, IL 60461 | 2016-08-02 |
1205286747 | Shirlene Umali | Registered Nurse | 20201 South Crawford Ave, Olympia Fields, IL 60461 | 2016-06-15 |
1386002590 | Touch of Wholeness Psychological Services, LLC | Psychologist | 20280 Governors Dr, Suite 207, Olympia Fields, IL 60461 | 2016-02-02 |
1063895357 | David Dardick | Dentist | 20180 Governors Hwy Ste 104, Olympia Fields, IL 60461 | 2015-07-04 |
1811378623 | Fins Healthcare Agency | Nursing Care | 3612 Lincohn Highway, Suite 19, Olympia Fields, IL 60461 | 2015-06-17 |
1285048959 | Garud Ranga Raj | Orthopaedic Surgery | 20817 Alexander St, Olympia Fields, IL 60461 | 2014-06-20 |
1811316334 | Brett Hapeman | Emergency Medicine | 20201 S Crawford, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2014-04-11 |
Find all providers in zip 60461 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730699182 | Andrea Russell | Counselor | 20280 Governors Hwy Ste 207, Olympia Fields, IL 60461-1028 | 2017-10-11 |
1447623194 | Georgia Soltau | Counselor | 20200 Governors Dr Ste 201e, Olympia Fields, IL 60461-1056 | 2015-11-03 |
1538464987 | Toren Turner | Counselor | 3612 Lincoln Hwy Ste 6, Olympia Fields, IL 60461-1637 | 2011-01-17 |
1912004086 | Donna Lee Ulanowski | Counselor | 3612 W Lincoln Highway, Suite 17 Personal Growth Center, Olympia Fields, IL 60461 | 2006-09-20 |
1558873877 | Lashiver Pate | Counselor | 2601 Lincoln Hwy, Olympia Fields, IL 60461-1862 | 2017-10-26 |
1609230556 | Laurie Reed | Counselor | 2601 Lincoln Hwy, Suite 101, Olympia Fields, IL 60461-1862 | 2016-04-06 |
1639534829 | Renaissance Therapy Services | Counselor | 20200 Governors Dr Ste 201e, Olympia Fields, IL 60461-1056 | 2015-12-15 |
1760892186 | Shannon Word | Counselor | 2601 Lincoln Hwy, Ste 106, Olympia Fields, IL 60461-1862 | 2014-05-07 |
1942627971 | Personal Growth Center, Ltd. | Counselor | 3612 Lincoln Hwy, Suite 6, Olympia Fields, IL 60461-1627 | 2014-03-27 |
1548345820 | Bunifaye Canty-gray | Counselor | 3612 Lincoln Hwy, Suite17, Olympia Fields, IL 60461-1627 | 2006-10-26 |
Find all providers in OLYMPIA FIELDS |
City | OLYMPIA FIELDS |
Zip Code | 60461 |
Please comment or provide details below to improve the information on PURE ABUNDANT WELLNESS CENTER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.