| Practice Wellness First Llc | |
|
8170 Mccormick Blvd Ste 204 Skokie IL 60076-2914 | |
| (847) 410-2029 | |
| (847) 410-2041 |
| Full Name | Practice Wellness First Llc |
|---|---|
| Speciality | Psychologist |
| Location | 8170 Mccormick Blvd Ste 204, Skokie, Illinois |
| Authorized Official Name and Position | Mary Worden (PROVIDER) |
| Authorized Official Contact | 8474102029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Practice Wellness First Llc 8170 Mccormick Blvd Ste 204 Skokie IL 60076-2914 Ph: (847) 410-2029 | Practice Wellness First Llc 8170 Mccormick Blvd Ste 204 Skokie IL 60076-2914 Ph: (847) 410-2029 |
| NPI Number | 1881115418 |
|---|---|
| Provider Enumeration Date | 07/05/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6507137676 |
|---|---|
| Medicare Enrollment ID | O20170808001679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881115418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071005991 (Illinois) | Primary |
| Provider Name | Mary E Worden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578546156 PECOS PAC ID: 0042242125 Enrollment ID: I20050909000331 |
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