| Contemporary Wellness, Llc | |
|
4300 Commerce Court Suite 300-9 Lisle IL 60532 | |
| (773) 739-0992 | |
| (773) 733-4119 |
| Full Name | Contemporary Wellness, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4300 Commerce Court, Lisle, Illinois |
| Authorized Official Name and Position | Grazyna G Petersen (FOUNDER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7737390992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Contemporary Wellness, Llc 1337 Goldenrod Dr Batavia IL 60510-3201 Ph: (773) 739-0992 | Contemporary Wellness, Llc 4300 Commerce Court Suite 300-9 Lisle IL 60532 Ph: (773) 739-0992 |
| NPI Number | 1326675760 |
|---|---|
| Provider Enumeration Date | 03/25/2020 |
| Last Update Date | 05/21/2020 |
| Certification Date | 05/21/2020 |
| Medicare PECOS PAC ID | 9830520436 |
|---|---|
| Medicare Enrollment ID | O20200515000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326675760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Grazyna Gabriela Petersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457814360 PECOS PAC ID: 0749611341 Enrollment ID: I20200515000058 |
| Provider Name | Kaitlin Marie Block |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740994086 PECOS PAC ID: 7810343837 Enrollment ID: I20231027001377 |
| Provider Name | B. Dawn Spahr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437278660 PECOS PAC ID: 1658717566 Enrollment ID: I20240314001175 |
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