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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