Organization
NORTHWEST ADULT WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD KHAMIS MD (PRESIDENT)
(773) 468-2110
Entity
Organization
Contact information
Practice address
235 W 95TH SUITE 3, CHICAGO, IL 60628
(773) 468-2110
Mailing address
5352 N LINCOLN AVE, CHICAGO, IL 60625-2316
(773) 353-5047
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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