| Sg Wellness Llc | |
|
1603 Orrington Ave Ste 600 Evanston IL 60201-3860 | |
| (847) 861-7899 | |
| Not Available |
| Full Name | Sg Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1603 Orrington Ave Ste 600, Evanston, Illinois |
| Authorized Official Name and Position | Therese Given (LCSW) |
| Authorized Official Contact | 8478617899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sg Wellness Llc 1603 Orrington Ave Ste 600 Evanston IL 60201-3860 Ph: (847) 861-7899 | Sg Wellness Llc 1603 Orrington Ave Ste 600 Evanston IL 60201-3860 Ph: (847) 861-7899 |
| NPI Number | 1952887812 |
|---|---|
| Provider Enumeration Date | 07/13/2018 |
| Last Update Date | 08/10/2022 |
| Certification Date | 08/10/2022 |
| Medicare PECOS PAC ID | 3779834486 |
|---|---|
| Medicare Enrollment ID | O20180919002454 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952887812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Therese Given |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821376187 PECOS PAC ID: 8224260633 Enrollment ID: I20140702002351 |
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