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Organization
INNER WELLNESS OF CENTRAL ILLINOIS PLLC
Active
Organization
INNER WELLNESS OF CENTRAL ILLINOIS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CHRISTINE ALEXANDER APN (MEDICAL DIRECTOR)
(309) 670-0459
Entity
Organization
Contact information
Practice address
2511 N MAIN ST, EAST PEORIA, IL 61611
(309) 670-0459
(309) 670-0416
Mailing address
2511 N MAIN ST, EAST PEORIA, IL 61611
(309) 670-0459
(309) 670-0416
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205098480
NPI
IL
01
—
1205470168
NPI
—
01
—
1992233977
NPI
IL
Enumeration date
07/06/2021
Last updated
08/13/2021
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