Provider Demographics
NPI:1326675760
Name:CONTEMPORARY WELLNESS, LLC
Entity Type:Organization
Organization Name:CONTEMPORARY WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:GRAZYNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC
Authorized Official - Phone:773-739-0992
Mailing Address - Street 1:1337 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-3201
Mailing Address - Country:US
Mailing Address - Phone:773-739-0992
Mailing Address - Fax:
Practice Address - Street 1:4300 COMMERCE COURT
Practice Address - Street 2:SUITE 300-9
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532
Practice Address - Country:US
Practice Address - Phone:773-739-0992
Practice Address - Fax:773-733-4119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-25
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty