Chicago Wellness and Support LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

CHICAGO WELLNESS AND SUPPORT LLC

Practice address

2833 E 79TH St
Chicago, IL 60649-5213

Phone

(773) 873-7335

NPI assigned

Sep 17, 2024

Organization subpart

No

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

Authorized official

Name

Blake Walker

Title

Owner

Phone

(480) 619-0949

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1215764873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16211 N SCOTTSDALE RD STE A6A267",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852541584",
            "telephone_number": "480-619-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 E 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606495213",
            "telephone_number": "773-873-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO WELLNESS AND SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-619-0949"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Vein Institute S.C.
• Chicago Vna, Inc.
• Chicago Voice & Swallowing Centers, LTD
• Chicago Volunteer Doulas
• Chicago Weight Loss Clinic, LLC
• Chicago Wellness Center for Families PLLC
• Chicago Wellness Center LTD
• Chicago Women'S AIDS Project
• Chicago Women'S Health Center
• Chicago Women'S Health Group at Northwestern

• Adolescent and Children Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adolescent and Children Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.