| Wise Health Professional Corporation | |
|
1127 N. Oakley Ave 5th Floor Chicago IL 60622-3507 | |
| (773) 989-9868 | |
| (773) 989-9824 |
| Full Name | Wise Health Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1127 N. Oakley Ave, Chicago, Illinois |
| Authorized Official Name and Position | Shephali A Patel (PRESIDENT) |
| Authorized Official Contact | 8473229602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Health Professional Corporation 1127 N. Oakley Ave 5th Floor Chicago IL 60622-3507 Ph: (773) 989-9868 | Wise Health Professional Corporation 1127 N. Oakley Ave 5th Floor Chicago IL 60622-3507 Ph: (773) 989-9868 |
| NPI Number | 1891969903 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 02/22/2024 |
| Medicare PECOS PAC ID | 4789743436 |
|---|---|
| Medicare Enrollment ID | O20081110000517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891969903 | NPI | - | NPPES |
| 036091776 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036091776 (Illinois) | Primary |
| Provider Name | Shephali Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063592095 PECOS PAC ID: 2264591916 Enrollment ID: I20081110000506 |
| Provider Name | Patsy A Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972771251 PECOS PAC ID: 9739224130 Enrollment ID: I20120413000405 |
| Provider Name | Letasha Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033476080 PECOS PAC ID: 4587812920 Enrollment ID: I20160211002154 |
| Provider Name | Lisa A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477914158 PECOS PAC ID: 0547569238 Enrollment ID: I20160713000151 |
| Provider Name | Megan Swidler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407201320 PECOS PAC ID: 5597053579 Enrollment ID: I20161006000795 |
| Provider Name | Nelson P Tamala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043762453 PECOS PAC ID: 5698056372 Enrollment ID: I20170112000123 |
| Provider Name | Stanley A Ruder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477099935 PECOS PAC ID: 2769767391 Enrollment ID: I20170322002807 |
| Provider Name | Mark Norbert Guiab |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346770914 PECOS PAC ID: 7113284142 Enrollment ID: I20171130000210 |
| Provider Name | Patricia Grayson-canty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841768660 PECOS PAC ID: 9830434497 Enrollment ID: I20181231000732 |
| Provider Name | Dajauna Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699330910 PECOS PAC ID: 0941535272 Enrollment ID: I20201208001519 |
| Provider Name | Adebowale Oyebamiji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790385987 PECOS PAC ID: 9234541061 Enrollment ID: I20201218001057 |
| Provider Name | Emmanuel Annang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336742568 PECOS PAC ID: 3971916511 Enrollment ID: I20201229000328 |
| Provider Name | Wanda Cegers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902440969 PECOS PAC ID: 8123434537 Enrollment ID: I20210310000771 |
| Provider Name | Robert B Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881291342 PECOS PAC ID: 9739596255 Enrollment ID: I20210330001929 |
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