| Mwc Foundation Inc. | |
|
900 Ridge Rd Ste 1s Homewood IL 60430-1934 | |
| (708) 637-1672 | |
| (708) 637-1633 |
| Full Name | Mwc Foundation Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 900 Ridge Rd Ste 1s, Homewood, Illinois |
| Authorized Official Name and Position | Jevita Renee' Hamilton (OWNER) |
| Authorized Official Contact | 7086371672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mwc Foundation Inc. 900 Ridge Rd Ste 1s Homewood IL 60430-1934 Ph: (708) 637-1672 | Mwc Foundation Inc. 900 Ridge Rd Ste 1s Homewood IL 60430-1934 Ph: (708) 637-1672 |
| NPI Number | 1275145716 |
|---|---|
| Provider Enumeration Date | 08/17/2020 |
| Last Update Date | 08/17/2020 |
| Certification Date | 08/17/2020 |
| Medicare PECOS PAC ID | 1951713155 |
|---|---|
| Medicare Enrollment ID | O20201211001932 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275145716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jevita Renee' Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942791371 PECOS PAC ID: 2860804069 Enrollment ID: I20201215001557 |
| Provider Name | Breanna B Hollie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023524469 PECOS PAC ID: 1355740341 Enrollment ID: I20210524002878 |
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