Tristate Wellness Mgt Llc

LBN: Tristate Wellness Mgt Llc
Tristate Wellness Mgt Llc is an health care organization with primary practice located at 2826 N Talman Unit J, Chicago IL 60618-7828. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Tristate Wellness Mgt Llc can be contacted via phone (708) 646-5738, or through Thompson, Philip Douglas via phone (708) 646-5738.

Contact Information

Primary practice address
2826 N Talman Unit J Chicago IL 60618-7828
Phone: (708) 646-5738
Fax: (866) 587-1485
Website:
Map and Directions
Authorized official contact:
Name: Thompson, Philip Douglas
Phone: (708) 646-5738

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 336-008797 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 036093462 Illinois

Profile Details

NPI number 1609821164
LBN Legal business name Tristate Wellness Mgt Llc
DBA Doing business as
Authorized official Thompson, Philip Douglas
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2006
Last updated Jan 8th, 2008 - about 17 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 1609821164 NPPES
Illinois MEDICAID 036039387
Illinois MEDICAID 036093462

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