| New Leaf Wellness & Behavioral Health | |
|
22100 Meadow Lake Pl Richton Park IL 60471-1299 | |
| (219) 973-7159 | |
| Not Available |
| Full Name | New Leaf Wellness & Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 22100 Meadow Lake Pl, Richton Park, Illinois |
| Authorized Official Name and Position | Kim Anderson (OWNER) |
| Authorized Official Contact | 2199737159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Wellness & Behavioral Health 22100 Meadow Lake Pl Richton Park IL 60471-1299 Ph: (219) 973-7159 | New Leaf Wellness & Behavioral Health 22100 Meadow Lake Pl Richton Park IL 60471-1299 Ph: (219) 973-7159 |
| NPI Number | 1396328183 |
|---|---|
| Provider Enumeration Date | 04/30/2021 |
| Last Update Date | 04/06/2022 |
| Medicare PECOS PAC ID | 7012303621 |
|---|---|
| Medicare Enrollment ID | O20220407002091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396328183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kim Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841729985 PECOS PAC ID: 0042582835 Enrollment ID: I20210311000508 |
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