Provider Demographics
NPI:1013941269
Name:HEALTH & WELLNESS P C
Entity Type:Organization
Organization Name:HEALTH & WELLNESS P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:847-593-2007
Mailing Address - Street 1:800 BIESTERFIELD RD
Mailing Address - Street 2:SUITE 2007
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3311
Mailing Address - Country:US
Mailing Address - Phone:847-593-2007
Mailing Address - Fax:847-593-7830
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:SUITE 2007
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3311
Practice Address - Country:US
Practice Address - Phone:847-593-2007
Practice Address - Fax:847-593-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2222162OtherBLUE CROSS BLUE SHIELD
IL211706Medicare ID - Type Unspecified
ILF03000Medicare UPIN