Provider Demographics
NPI:1093318164
Name:VICTRESS, A WELLNESS CENTER FOR WOMEN, INC
Entity Type:Organization
Organization Name:VICTRESS, A WELLNESS CENTER FOR WOMEN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-261-5728
Mailing Address - Street 1:15255 S 94TH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3895
Mailing Address - Country:US
Mailing Address - Phone:708-261-5728
Mailing Address - Fax:
Practice Address - Street 1:7110 W 127TH ST STE 150
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1579
Practice Address - Country:US
Practice Address - Phone:708-261-5728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)