Provider Demographics
NPI:1760236004
Name:PURE WELLNESS CLINIC, PLLC
Entity Type:Organization
Organization Name:PURE WELLNESS CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YULIYA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RASHEVSKA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:708-745-0832
Mailing Address - Street 1:5048 PRAIRIE SAGE LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4321
Mailing Address - Country:US
Mailing Address - Phone:708-745-0832
Mailing Address - Fax:
Practice Address - Street 1:535 PLAINFIELD RD STE C
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7608
Practice Address - Country:US
Practice Address - Phone:708-745-0832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty