Organization
WELLNESS SPECIALISTS, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IRENE G GONZAGA RN (ADMINISTRATOR)
(630) 780-6956
Entity
Organization
Contact information
Practice address
330 E ROOSEVELT RD, STE 2B4, LOMBARD, IL 60148-4640
(630) 780-6956
(630) 873-2041
Mailing address
330 E ROOSEVELT RD, STE 2B4, LOMBARD, IL 60148-4644
(630) 780-6956
(630) 873-2041
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1011185
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011185
STATE LICENSE
IL
Enumeration date
02/05/2010
Last updated
02/05/2010
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