Organization
WELLSPRING CLINICAL ASSOCIATES, INC.
Active
Other names
Integrated Healthcare Solutions Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS LEO DIMATTEO M.D. (PRESIDENT)
(630) 541-8930
Entity
Organization
Contact information
Practice address
5950 LINCOLN AVE, UNIT W, LISLE, IL 60532-3388
(630) 541-8930
(630) 541-8940
Mailing address
5950 LINCOLN AVE, UNIT W, LISLE, IL 60532-3388
(630) 541-8930
(630) 541-8940
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022-32842
BC/BS
—
01
—
02227624
BLUE CROSS BLUE SHIELD
—
01
—
02232842
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/07/2007
Last updated
10/07/2009
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