| Elemental Care - Health & Wellness Center, Llc | |
|
20660 Caton Farm Rd Unit F Crest Hill IL 60403-1201 | |
| (815) 714-5430 | |
| (815) 714-5369 |
| Full Name | Elemental Care - Health & Wellness Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20660 Caton Farm Rd, Crest Hill, Illinois |
| Authorized Official Name and Position | Christopher Michael Galloway (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 8157145430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elemental Care - Health & Wellness Center, Llc 20660 Caton Farm Rd Unit F Crest Hill IL 60403-1201 Ph: (815) 714-5430 | Elemental Care - Health & Wellness Center, Llc 20660 Caton Farm Rd Unit F Crest Hill IL 60403-1201 Ph: (815) 714-5430 |
| NPI Number | 1568908739 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 01/05/2023 |
| Certification Date | 01/05/2023 |
| Medicare PECOS PAC ID | 6709160211 |
|---|---|
| Medicare Enrollment ID | O20170301001134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568908739 | NPI | - | NPPES |
| Provider Name | Facundo Benito Dovale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689798696 PECOS PAC ID: 7618062928 Enrollment ID: I20071002000413 |
| Provider Name | Christopher Michael Galloway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346613718 PECOS PAC ID: 6709189939 Enrollment ID: I20160122000448 |
| Provider Name | Katherine Joanne Skurski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366903866 PECOS PAC ID: 8820331556 Enrollment ID: I20190522000072 |
| Provider Name | Virginia Bahena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992411987 PECOS PAC ID: 2264887488 Enrollment ID: I20231009000985 |
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