Provider Demographics
NPI:1013486083
Name:CARE WANYANA LLC
Entity Type:Organization
Organization Name:CARE WANYANA LLC
Other - Org Name:EMBRACE INTEGRAL CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WANYANA
Authorized Official - Suffix:
Authorized Official - Credentials:APN, PMHNP-BC
Authorized Official - Phone:630-303-3426
Mailing Address - Street 1:3701 ALGONQUIN RD STE 1050
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3127
Mailing Address - Country:US
Mailing Address - Phone:847-305-3250
Mailing Address - Fax:815-806-1205
Practice Address - Street 1:3701 ALGONQUIN RD STE 1050
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-3127
Practice Address - Country:US
Practice Address - Phone:847-305-3250
Practice Address - Fax:815-806-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277000743OtherAPN