| New Moon Wellness, Pllc | |
|
2606 Marian Ln Wilmette IL 60091-2208 | |
| (312) 852-0580 | |
| Not Available |
| Full Name | New Moon Wellness, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2606 Marian Ln, Wilmette, Illinois |
| Authorized Official Name and Position | Margaret A Duros (SOLE MEMBER) |
| Authorized Official Contact | 3128520580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Moon Wellness, Pllc 2606 Marian Ln Wilmette IL 60091-2208 Ph: (312) 852-0580 | New Moon Wellness, Pllc 2606 Marian Ln Wilmette IL 60091-2208 Ph: (312) 852-0580 |
| NPI Number | 1174106207 |
|---|---|
| Provider Enumeration Date | 05/05/2021 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 7315356771 |
|---|---|
| Medicare Enrollment ID | O20210514001799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174106207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Margaret A Duros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245310804 PECOS PAC ID: 1850486556 Enrollment ID: I20070926000617 |
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