Provider Demographics
NPI:1790497758
Name:PRINGLOW HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:PRINGLOW HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:GLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:IKERODAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:733-676-4076
Mailing Address - Street 1:11341 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-9248
Mailing Address - Country:US
Mailing Address - Phone:773-676-4076
Mailing Address - Fax:
Practice Address - Street 1:11341 HUMMINGBIRD LN
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-9248
Practice Address - Country:US
Practice Address - Phone:773-676-4076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care