Provider Demographics
NPI:1649066895
Name:MPOWER WELLNESS LLC
Entity type:Organization
Organization Name:MPOWER WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-951-5139
Mailing Address - Street 1:3223 LAKE AVE STE 15C
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1069
Mailing Address - Country:US
Mailing Address - Phone:847-951-5139
Mailing Address - Fax:
Practice Address - Street 1:7222 W CERMAK RD STE 504
Practice Address - Street 2:
Practice Address - City:NORTH RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-1443
Practice Address - Country:US
Practice Address - Phone:773-620-7613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity MedicineGroup - Single Specialty