Provider Demographics
NPI:1275390148
Name:XPRESS MEDICAL & WELLNESS INC.
Entity Type:Organization
Organization Name:XPRESS MEDICAL & WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:URIBE
Authorized Official - Suffix:
Authorized Official - Credentials:FPA-APRN, FNP-BC
Authorized Official - Phone:630-312-9282
Mailing Address - Street 1:16W718 90TH ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6003
Mailing Address - Country:US
Mailing Address - Phone:630-312-9282
Mailing Address - Fax:630-618-3977
Practice Address - Street 1:14620 S LA GRANGE RD STE 2
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2581
Practice Address - Country:US
Practice Address - Phone:630-312-9282
Practice Address - Fax:630-618-3977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty