Organization
BRAIN AND WELLNESS INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAGAMANI PAVULURI MD (OWNER)
(312) 636-8671
Entity
Organization
Contact information
Practice address
1165 N CLARK ST STE 700, CHICAGO, IL 60610-2821
(312) 636-8671
Mailing address
30 W OAK ST APT 14A, CHICAGO, IL 60610-8724
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036101082
IL
Other
Enumeration date
03/01/2018
Last updated
05/23/2024
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