| Triple G Wellness Corporation | |
|
613 E 67th St Chicago IL 60637-4122 | |
| (773) 435-9493 | |
| Not Available |
| Full Name | Triple G Wellness Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 613 E 67th St, Chicago, Illinois |
| Authorized Official Name and Position | Cornelius Rogers (OWNER) |
| Authorized Official Contact | 7734359493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triple G Wellness Corporation 613 E 67th St Chicago IL 60637-4122 Ph: (773) 435-9493 | Triple G Wellness Corporation 613 E 67th St Chicago IL 60637-4122 Ph: (773) 435-9493 |
| NPI Number | 1790673903 |
|---|---|
| Provider Enumeration Date | 06/26/2025 |
| Last Update Date | 06/26/2025 |
| Certification Date | 06/25/2025 |
| Medicare PECOS PAC ID | 4284138405 |
|---|---|
| Medicare Enrollment ID | O20250919000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790673903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Cornelius a Rogers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285644591 PECOS PAC ID: 3476455213 Enrollment ID: I20070530000485 |
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