| Triwellness | |
|
4055 W Peterson Ave Ste 201 Chicago IL 60646-6183 | |
| (224) 518-4547 | |
| Not Available |
| Full Name | Triwellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 4055 W Peterson Ave Ste 201, Chicago, Illinois |
| Authorized Official Name and Position | Aarti S. Felder (PRESIDENT/CLINICAL DIRECTOR) |
| Authorized Official Contact | 2245184547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triwellness 4055 W Peterson Ave Ste 201 Chicago IL 60646-6183 Ph: (224) 518-4547 | Triwellness 4055 W Peterson Ave Ste 201 Chicago IL 60646-6183 Ph: (224) 518-4547 |
| NPI Number | 1871001289 |
|---|---|
| Provider Enumeration Date | 01/19/2018 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/18/2024 |
| Medicare PECOS PAC ID | 9436590163 |
|---|---|
| Medicare Enrollment ID | O20240513003391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871001289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 101YP2500X | Counselor - Professional | (NU) | Secondary |
| Provider Name | Aarti S Felder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457716268 PECOS PAC ID: 3072954700 Enrollment ID: I20240513003479 |
| Provider Name | Jessie Duncan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043950900 PECOS PAC ID: 0143769182 Enrollment ID: I20240822001592 |
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