| River North Wellness Center Llc | |
|
405 N Wabash Ave Ste P2-a Chicago IL 60611-3744 | |
| (773) 850-1095 | |
| Not Available |
| Full Name | River North Wellness Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 405 N Wabash Ave Ste P2-a, Chicago, Illinois |
| Authorized Official Name and Position | Mona Khan (OWNER) |
| Authorized Official Contact | 3129985229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River North Wellness Center Llc 405 N Wabash Ave Ste P2-a Chicago IL 60611-3744 Ph: () - | River North Wellness Center Llc 405 N Wabash Ave Ste P2-a Chicago IL 60611-3744 Ph: (773) 850-1095 |
| NPI Number | 1972213643 |
|---|---|
| Provider Enumeration Date | 12/02/2022 |
| Last Update Date | 12/02/2022 |
| Medicare PECOS PAC ID | 3779956859 |
|---|---|
| Medicare Enrollment ID | O20230310002396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972213643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mona Khan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073820775 PECOS PAC ID: 0244663235 Enrollment ID: I20191205000671 |
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