| Evergreen Health & Wellness Inc. | |
|
222 W 26th St Ste A Chicago IL 60616-4099 | |
| (312) 763-6192 | |
| (312) 277-3533 |
| Full Name | Evergreen Health & Wellness Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 222 W 26th St Ste A, Chicago, Illinois |
| Authorized Official Name and Position | Xiuzhen Li (PRESIDENT) |
| Authorized Official Contact | 3127316185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Health & Wellness Inc. 222 W 26th St Ste A Chicago IL 60616-4099 Ph: (312) 731-6185 | Evergreen Health & Wellness Inc. 222 W 26th St Ste A Chicago IL 60616-4099 Ph: (312) 763-6192 |
| NPI Number | 1720626484 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 08/25/2024 |
| Medicare PECOS PAC ID | 3678909074 |
|---|---|
| Medicare Enrollment ID | O20200203002400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720626484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Xiuzhen Li |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1699319996 PECOS PAC ID: 4587090980 Enrollment ID: I20200203002448 |
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