Provider Demographics
NPI:1467003145
Name:LOQUI WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:LOQUI WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRONDORF
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:610-888-3595
Mailing Address - Street 1:1337 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4829
Mailing Address - Country:US
Mailing Address - Phone:610-888-3595
Mailing Address - Fax:
Practice Address - Street 1:1337 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4829
Practice Address - Country:US
Practice Address - Phone:610-888-3595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health