| Wellbe Utah Llc | |
|
225 W Washington St Ste 1500 Chicago IL 60606-3485 | |
| (312) 776-2422 | |
| Not Available |
| Full Name | Wellbe Utah Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 225 W Washington St Ste 1500, Chicago, Illinois |
| Authorized Official Name and Position | Jeffrey Kang (PRESIDENT AND CEO) |
| Authorized Official Contact | 3127762412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellbe Utah Llc 225 W Washington St Ste 1500 Chicago IL 60606-3485 Ph: (312) 776-2422 | Wellbe Utah Llc 225 W Washington St Ste 1500 Chicago IL 60606-3485 Ph: (312) 776-2422 |
| NPI Number | 1568183523 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/08/2022 |
| Medicare PECOS PAC ID | 6002292034 |
|---|---|
| Medicare Enrollment ID | O20220928003465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568183523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Heather Sojourner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992719884 PECOS PAC ID: 8224078712 Enrollment ID: I20050505000096 |
| Provider Name | Gretchen Leathers Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508054776 PECOS PAC ID: 8820179534 Enrollment ID: I20080123000701 |
| Provider Name | Brandi L Bolton Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811176761 PECOS PAC ID: 3375626583 Enrollment ID: I20080212000125 |
| Provider Name | Taylor Swenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245696913 PECOS PAC ID: 8426335415 Enrollment ID: I20170428001489 |
| Provider Name | Annliza Lachica Piacitelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205034113 PECOS PAC ID: 6507054046 Enrollment ID: I20171006000672 |
| Provider Name | Cody J Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962088732 PECOS PAC ID: 3779897285 Enrollment ID: I20210621002257 |
| Provider Name | Joseph Trimble Lyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376206862 PECOS PAC ID: 4880086032 Enrollment ID: I20220119002938 |
| Provider Name | Jeffrey Ling Kang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710429410 PECOS PAC ID: 8729231261 Enrollment ID: I20220928003490 |
| Provider Name | Charles L Head |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295423283 PECOS PAC ID: 6709244437 Enrollment ID: I20230628000116 |
| Provider Name | Kidist Fisseha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356032262 PECOS PAC ID: 3072975614 Enrollment ID: I20230815001218 |
| Provider Name | Ian M Samuelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932510534 PECOS PAC ID: 3173740768 Enrollment ID: I20231117002921 |
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