Provider Demographics
NPI:1295294700
Name:WHOLISTIC CARE, INC
Entity type:Organization
Organization Name:WHOLISTIC CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TSCHAMPA LOPOTKO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, RPH
Authorized Official - Phone:630-790-9488
Mailing Address - Street 1:311 MERTON AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5203
Mailing Address - Country:US
Mailing Address - Phone:630-790-9488
Mailing Address - Fax:630-545-3630
Practice Address - Street 1:311 MERTON AVE
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5203
Practice Address - Country:US
Practice Address - Phone:630-790-9488
Practice Address - Fax:630-545-3630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1952767733OtherMENTAL HEALTH COUNSELOR