| Mobile Wellness Incorporated | |
|
10208 S Indianapolis Ave Ste 301 Chicago IL 60617-6033 | |
| (866) 413-1988 | |
| (866) 628-8599 |
| Full Name | Mobile Wellness Incorporated |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10208 S Indianapolis Ave Ste 301, Chicago, Illinois |
| Authorized Official Name and Position | Kimberly Travis (CEO) |
| Authorized Official Contact | 8664131988 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Wellness Incorporated 10208 S Indianapolis Ave Ste 301 Chicago IL 60617-6033 Ph: (866) 413-1988 | Mobile Wellness Incorporated 10208 S Indianapolis Ave Ste 301 Chicago IL 60617-6033 Ph: (866) 413-1988 |
| NPI Number | 1982292199 |
|---|---|
| Provider Enumeration Date | 01/04/2021 |
| Last Update Date | 07/27/2023 |
| Certification Date | 07/27/2023 |
| Medicare PECOS PAC ID | 6800204744 |
|---|---|
| Medicare Enrollment ID | O20210414002004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982292199 | NPI | - | NPPES |
| Provider Name | Kimberly N Travis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194017269 PECOS PAC ID: 6800032848 Enrollment ID: I20130418000378 |
| Provider Name | Valerie Perez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952651408 PECOS PAC ID: 1254556780 Enrollment ID: I20140625002007 |
| Provider Name | Karen Lynn Glaza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114426491 PECOS PAC ID: 4385883982 Enrollment ID: I20210518000167 |
| Provider Name | Melody Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801362041 PECOS PAC ID: 4385998483 Enrollment ID: I20230315000449 |
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