Glow Health and Wellness Medical Spa, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

209008594 Issued in IL

Legal business name

GLOW HEALTH AND WELLNESS MEDICAL SPA, PC

Practice address

1528 W Monroe St Ste 100
Chicago, IL 60607-2460

Phone

(630) 901-2879

NPI assigned

Sep 20, 2017

Last updated

Sep 20, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Tajuana D. Johnson, FNPNPI 1588969166

Title

Owner, Manager

Phone

(630) 901-2879

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tajuana Johnson, APN

  • Family Nurse Practitioner
  • Lisle, IL
  • NPI 1588969166
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1205345337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W 15TH ST UNIT 320",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 W MONROE ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072460",
            "telephone_number": "630-901-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW HEALTH AND WELLNESS MEDICAL SPA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TAJUANA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER, MANAGER",
        "authorized_official_telephone_number": "630-901-2879",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "209008594",
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "IL",
            "license": "209008594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pheophilus H Glover, PHARM.D.
• Treena Renee Glover
• Erin Michele Glovinsky Sanders, LCSW
• Glow Belmont Inc. (Glow Birth & Body)
• Glow Expressive Arts Therapy LLC
• Natalia Glowacka, PA
• Robert C Glowacki, PHARM.D.
• Suzanna Glowacki, OT
• Jakub Glowala
• Joseph L Glowiak, DC, MS

• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.