RTW Services PLLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Momence, IL
NPI 1194583328 · NPPES record last updated Mar 12, 2024
Key facts
- NPI
- 1194583328
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- RTW SERVICES PLLC
- Practice address
- 118 E Ohio St
Momence, IL 60954-1741 - Phone
- (269) 689-9055
- NPI assigned
- Mar 12, 2024
- Organization subpart
- No
Authorized official
- Name
- Robert Wirick, APRN
- Title
- Pwner/Provider
- Phone
- (269) 698-8055
Practitioners 1
-
Robert Wirick, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241003002095 | IL | Part B Supplier - Clinic/Group Practice | 4385175140 |
Receives reassigned benefits from 1 practitioner Practice locations: Mokena, IL; Momence, IL |
National Provider Directory
Locations
9550 Bormet Dr
Ste 106
Mokena, IL 60448
Phone (815) 665-4627
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
118 E Ohio St
Momence, IL 60954-1741
Mailing address
118 E Ohio St
Momence, IL 60954-1741
Other providers in Momence, IL
- Momence District #1
- Momence Meadows Nursing & Rehabilitation Center
- Momence Meadows Nursing and Rehabilitation Center
- Dana Marie Nunamaker
- Jennifer Melissa Powell
- Stonecrest Manor Assisted Living
- Lisa J Thompson-Dyson
- Mandi Ann Troli
- Robert Wirick
- Juan Zarate
All providers in Momence, IL · Psychiatric/Mental Health Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.