| Serene Women's Wellness | |
|
787 Sunset Blvd Ste 200 O Fallon IL 62269-1960 | |
| (618) 726-2229 | |
| Not Available |
| Full Name | Serene Women's Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 787 Sunset Blvd Ste 200, O Fallon, Illinois |
| Authorized Official Name and Position | Rebecca Hathaway (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 6182924887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serene Women's Wellness 787 Sunset Blvd Ste 200 O Fallon IL 62269-1960 Ph: (618) 726-2229 | Serene Women's Wellness 787 Sunset Blvd Ste 200 O Fallon IL 62269-1960 Ph: (618) 726-2229 |
| NPI Number | 1740776251 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 03/27/2019 |
| Medicare PECOS PAC ID | 9931458791 |
|---|---|
| Medicare Enrollment ID | O20180828001315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740776251 | NPI | - | NPPES |
| 036-125618 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Markel L Owens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659572451 PECOS PAC ID: 0244372951 Enrollment ID: I20100119000370 |
| Provider Name | Christina H Dothager |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508067596 PECOS PAC ID: 9133251614 Enrollment ID: I20100719000863 |
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