| Oswego Wellness, Inc | |
|
64 Main St Oswego IL 60543-9893 | |
| (630) 519-1010 | |
| (630) 405-7209 |
| Full Name | Oswego Wellness, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 64 Main St, Oswego, Illinois |
| Authorized Official Name and Position | Heather Ann Johnson (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6305191010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oswego Wellness, Inc 64 Main St Oswego IL 60543-9893 Ph: (630) 519-1010 | Oswego Wellness, Inc 64 Main St Oswego IL 60543-9893 Ph: (630) 519-1010 |
| NPI Number | 1912373069 |
|---|---|
| Provider Enumeration Date | 08/12/2015 |
| Last Update Date | 12/09/2022 |
| Certification Date | 12/09/2022 |
| Medicare PECOS PAC ID | 3274899844 |
|---|---|
| Medicare Enrollment ID | O20171115000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912373069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kelly Olenski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689064867 PECOS PAC ID: 3476833815 Enrollment ID: I20161201000539 |
| Provider Name | Heather Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902208929 PECOS PAC ID: 0244596815 Enrollment ID: I20171207000323 |
| Provider Name | Karyn M Kudrna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699234211 PECOS PAC ID: 9638411564 Enrollment ID: I20190425000680 |
| Provider Name | Amanda E Comer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619513645 PECOS PAC ID: 5799118436 Enrollment ID: I20191210002568 |
| Provider Name | Alicia Noyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154917201 PECOS PAC ID: 0941614853 Enrollment ID: I20210203002215 |
| Provider Name | Amy Brinkman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124132998 PECOS PAC ID: 2163838491 Enrollment ID: I20210310001799 |
| Provider Name | Kristen Rexha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265027452 PECOS PAC ID: 3173930401 Enrollment ID: I20210401001206 |
| Provider Name | Abby Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891146627 PECOS PAC ID: 9739596982 Enrollment ID: I20210406000380 |
| Provider Name | Derick P Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154903920 PECOS PAC ID: 8527469030 Enrollment ID: I20210622000906 |
| Provider Name | Lori Watts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770751356 PECOS PAC ID: 9638541279 Enrollment ID: I20230208002536 |
| Provider Name | Robert Healy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134778152 PECOS PAC ID: 7911379565 Enrollment ID: I20230208002966 |
| Provider Name | Melissa Pilar Tatum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972078350 PECOS PAC ID: 5890152722 Enrollment ID: I20230607002010 |
| Provider Name | Lauren Marasco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295515039 PECOS PAC ID: 7719333608 Enrollment ID: I20231030000930 |
| Provider Name | Brianne Kalusniak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497454078 PECOS PAC ID: 1557718764 Enrollment ID: I20231109002092 |
| Provider Name | Elise Pullen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366229361 PECOS PAC ID: 7416304639 Enrollment ID: I20231109002329 |
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