| 4s Wellness Services | |
|
305 Wayne St Park Forest IL 60466-1327 | |
| (708) 466-8853 | |
| (708) 367-9980 |
| Full Name | 4s Wellness Services |
|---|---|
| Speciality | Psychologist |
| Location | 305 Wayne St, Park Forest, Illinois |
| Authorized Official Name and Position | Marlayna Antionette Warren (CEO) |
| Authorized Official Contact | 7084668853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 4s Wellness Services 305 Wayne St Park Forest IL 60466-1327 Ph: (708) 466-8853 | 4s Wellness Services 305 Wayne St Park Forest IL 60466-1327 Ph: (708) 466-8853 |
| NPI Number | 1487324083 |
|---|---|
| Provider Enumeration Date | 09/15/2021 |
| Last Update Date | 09/15/2021 |
| Certification Date | 09/15/2021 |
| Medicare PECOS PAC ID | 1355722893 |
|---|---|
| Medicare Enrollment ID | O20220715000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487324083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
| Provider Name | Larry L Wilkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942623525 PECOS PAC ID: 4284856204 Enrollment ID: I20141106001857 |
| Provider Name | Monique Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831789346 PECOS PAC ID: 2163876210 Enrollment ID: I20230925000663 |
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