Provider Demographics
NPI:1417022518
Name:INCLUSIVE WELLNESS, LTD.
Entity Type:Organization
Organization Name:INCLUSIVE WELLNESS, LTD.
Other - Org Name:INCLUSIVE WELLNESS, LTD.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHABI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, DC, FIAMA
Authorized Official - Phone:312-774-0010
Mailing Address - Street 1:1603 ORRINGTON AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3860
Mailing Address - Country:US
Mailing Address - Phone:312-774-0010
Mailing Address - Fax:
Practice Address - Street 1:4705 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2009
Practice Address - Country:US
Practice Address - Phone:888-978-8287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1632537OtherBCBS
IL1632537OtherBCBS