# HEART OF TRANSFORMATION WELLNESS INSTITUTE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275926123
- **Authorized official:** DR. ARCHANA LAL-TABAK M.D. (PRESIDENT)
- **Authorized official phone:** (847) 425-9355

## Contact information

- **Practice address:** 1618 ORRINGTON AVE, SUITE 206, EVANSTON, IL 60201-5016
- **Practice address phone:** (847) 425-9355
- **Practice address fax:** (847) 424-9765
- **Mailing address:** 1618 ORRINGTON AVE, SUITE 206, EVANSTON, IL 60201-5016
- **Mailing address phone:** (847) 425-9355
- **Mailing address fax:** (847) 424-9765

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 036.079471 | IL | — |
| 261Q00000X | Clinic/Center | 042.619453 | IL | Yes |

## Other

- **Enumeration date:** 03/16/2015
- **Last updated:** 03/16/2015