| Prosper Health And Wellness | |
|
7901 W 159th St Tinley Park IL 60477-1881 | |
| (312) 279-9814 | |
| (312) 279-9879 |
| Full Name | Prosper Health And Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 7901 W 159th St, Tinley Park, Illinois |
| Authorized Official Name and Position | Gladys Larsen (FOUNDER-CEO) |
| Authorized Official Contact | 3122799184 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosper Health And Wellness 122 S Michigan Ave Chicago IL 60603-6191 Ph: (312) 279-9814 | Prosper Health And Wellness 7901 W 159th St Tinley Park IL 60477-1881 Ph: (312) 279-9814 |
| NPI Number | 1619572419 |
|---|---|
| Provider Enumeration Date | 12/01/2020 |
| Last Update Date | 06/14/2023 |
| Medicare PECOS PAC ID | 0446654529 |
|---|---|
| Medicare Enrollment ID | O20210811003153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619572419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Gladys Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174974661 PECOS PAC ID: 2567746738 Enrollment ID: I20170307001986 |
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