| Well-america Corporation | |
|
2501 Chatham Rd Springfield IL 62704-4188 | |
| (302) 526-4547 | |
| (302) 469-2115 |
| Full Name | Well-america Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 2501 Chatham Rd, Springfield, Illinois |
| Authorized Official Name and Position | Yasir J. Ahmad (OWNER) |
| Authorized Official Contact | 3025264547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Well-america Corporation 79 Ogle Rd Old Tappan NJ 07675-7026 Ph: (302) 526-4547 | Well-america Corporation 2501 Chatham Rd Springfield IL 62704-4188 Ph: (302) 526-4547 |
| NPI Number | 1033852603 |
|---|---|
| Provider Enumeration Date | 04/20/2022 |
| Last Update Date | 04/20/2022 |
| Certification Date | 04/20/2022 |
| Medicare PECOS PAC ID | 3072991637 |
|---|---|
| Medicare Enrollment ID | O20220609002914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033852603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nicole M Montalvo Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740676584 PECOS PAC ID: 2860793130 Enrollment ID: I20151211000496 |
| Provider Name | Kimberly Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063927291 PECOS PAC ID: 2961760764 Enrollment ID: I20220623002254 |
| Provider Name | Alexa Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336873330 PECOS PAC ID: 7416330212 Enrollment ID: I20220811000917 |
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