| Powers Wellness & Consulting Group, Llc | |
|
912 Blazing Star Rd Grayslake IL 60030-3555 | |
| (773) 332-7692 | |
| (847) 816-9724 |
| Full Name | Powers Wellness & Consulting Group, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 912 Blazing Star Rd, Grayslake, Illinois |
| Authorized Official Name and Position | Victoria Priola (PSYCHOLOGIST) |
| Authorized Official Contact | 7733327692 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Powers Wellness & Consulting Group, Llc 912 Blazing Star Rd Grayslake IL 60030-3555 Ph: (773) 332-7692 | Powers Wellness & Consulting Group, Llc 912 Blazing Star Rd Grayslake IL 60030-3555 Ph: (773) 332-7692 |
| NPI Number | 1649668260 |
|---|---|
| Provider Enumeration Date | 01/05/2015 |
| Last Update Date | 01/05/2015 |
| Medicare PECOS PAC ID | 8325361876 |
|---|---|
| Medicare Enrollment ID | O20150108001315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649668260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071006158 (Illinois) | Primary |
| Provider Name | Victoria J Priola |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124169735 PECOS PAC ID: 6305866856 Enrollment ID: I20150127000314 |
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