Organization
PREMIER WELLCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA A. VASICH (WELLNESS PROGRAM MANAGER)
(312) 898-5064
Entity
Organization
Contact information
Practice address
400 W. HIGGINS RD., PARK RIDGE, IL 60068
(312) 898-5064
Mailing address
115 S LA SALLE ST, SUITE 2600, CHICAGO, IL 60603-3801
(312) 898-5064
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/27/2012
Last updated
05/22/2012
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