Family Wellness Clinic Ltd

LBN: Family Wellness Clinic Ltd
Family Wellness Clinic Ltd is an health care organization with primary practice located at 410 E Northwest Hwy , Mount Prospect IL 60056-3305. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Family Wellness Clinic Ltd can be contacted via phone (847) 632-1680, or through Gomez, Raymond via phone (847) 632-1680.

Contact Information

Primary practice address
410 E Northwest Hwy Mount Prospect IL 60056-3305
Fax: (847) 632-1681
Website:
Authorized official contact:
Name: Gomez, Raymond Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036101711 Illinois

Profile Details

NPI number 1083763866
LBN Legal business name Family Wellness Clinic Ltd
DBA Doing business as
Authorized official Gomez, Raymond Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 9th, 2007
Last updated Sep 26th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083763866 NPPES
Illinois MEDICAID 036101711

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