| Baal Perazim Wellness, Inc | |
|
3416 S Halsted St Chicago IL 60608-6708 | |
| (773) 296-2400 | |
| (773) 296-1097 |
| Full Name | Baal Perazim Wellness, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3416 S Halsted St, Chicago, Illinois |
| Authorized Official Name and Position | Maurice Brownlee (PRESIDENT) |
| Authorized Official Contact | 7732962400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baal Perazim Wellness, Inc 2835 N Sheffield Ave Ste 500 Chicago IL 60657-5084 Ph: (773) 296-2400 | Baal Perazim Wellness, Inc 3416 S Halsted St Chicago IL 60608-6708 Ph: (773) 296-2400 |
| NPI Number | 1215403530 |
|---|---|
| Provider Enumeration Date | 10/15/2018 |
| Last Update Date | 05/12/2023 |
| Medicare PECOS PAC ID | 7618218587 |
|---|---|
| Medicare Enrollment ID | O20190607000040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215403530 | NPI | - | NPPES |
| 253231187001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Andra Munteanu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912934456 PECOS PAC ID: 6507847993 Enrollment ID: I20040601000873 |
| Provider Name | Marlene Tang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942401294 PECOS PAC ID: 2668521576 Enrollment ID: I20090526000435 |
| Provider Name | Daniel S Berger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710076237 PECOS PAC ID: 7214971845 Enrollment ID: I20100615000348 |
| Provider Name | Cheryl Mejta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861581365 PECOS PAC ID: 9638334139 Enrollment ID: I20120709000303 |
| Provider Name | Anthony P. Oltean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689962151 PECOS PAC ID: 0446492540 Enrollment ID: I20130819000653 |
| Provider Name | Victor C Okamgba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629434741 PECOS PAC ID: 8628372711 Enrollment ID: I20160210001753 |
| Provider Name | Imelda Homecgoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487010534 PECOS PAC ID: 9638461429 Enrollment ID: I20160715000158 |
| Provider Name | Maurice Brownlee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083145262 PECOS PAC ID: 9537435862 Enrollment ID: I20171031003176 |
| Provider Name | Debra L Conti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063621589 PECOS PAC ID: 0941572887 Enrollment ID: I20171130001521 |
| Provider Name | James R Belanger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851824908 PECOS PAC ID: 9931514171 Enrollment ID: I20210219001769 |
| Provider Name | Joseph Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336667955 PECOS PAC ID: 7012275191 Enrollment ID: I20230310000079 |
| Provider Name | Vincent Vargas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629234851 PECOS PAC ID: 5496925364 Enrollment ID: I20230315002618 |
| Provider Name | Stephanie Salamanca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083173066 PECOS PAC ID: 1951769306 Enrollment ID: I20230616002859 |
| Provider Name | Cathy Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740878925 PECOS PAC ID: 2163867508 Enrollment ID: I20240226002031 |
| Provider Name | Jason Hoffmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023620655 PECOS PAC ID: 5092154849 Enrollment ID: I20240412003831 |
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