Provider Demographics
NPI:1144235664
Name:OPTUM BIOMETRICS, INC.
Entity Type:Organization
Organization Name:OPTUM BIOMETRICS, INC.
Other - Org Name:WELLNESS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINWEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-974-1910
Mailing Address - Street 1:4205 WESTBROOK DRIVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504
Mailing Address - Country:US
Mailing Address - Phone:952-974-1910
Mailing Address - Fax:630-236-4772
Practice Address - Street 1:4205 WESTBROOK DRIVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504
Practice Address - Country:US
Practice Address - Phone:952-974-1910
Practice Address - Fax:630-236-4772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL902670Medicare ID - Type UnspecifiedROSTER BILLER MEDICARE