Provider Demographics
NPI:1619645983
Name:WELNOWSKI HEALTHCARE LLC
Entity Type:Organization
Organization Name:WELNOWSKI HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WELNOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-844-6600
Mailing Address - Street 1:28873 REDFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-5935
Mailing Address - Country:US
Mailing Address - Phone:800-323-3007
Mailing Address - Fax:630-579-1774
Practice Address - Street 1:1121 W OGDEN AVE APT 258
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2932
Practice Address - Country:US
Practice Address - Phone:630-881-5680
Practice Address - Fax:630-579-1774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty