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Organization
PURE ABUNDANT WELLNESS CENTER
Active
Organization
PURE ABUNDANT WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WALLACE EDD (CEO)
(708) 560-1235
Entity
Organization
Contact information
Practice address
20200 GOVERNORS DR, SUITE 107, OLYMPIA FIELDS, IL 60461-1032
(708) 560-1235
Mailing address
20200 GOVERNORS DR, SUITE 107, OLYMPIA FIELDS, IL 60461-1032
(708) 560-1235
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.008731
IL
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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