NPIMap

Organization Active NPI

Wheaton Wellness Center, Inc.

  • Counselor
  • Wheaton, IL
National Provider Identifier
1255807244
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
WHEATON WELLNESS CENTER, INC.
Practice address
212 S Main St
Wheaton, IL 60187-5232
Phone
(630) 664-1449
Fax
(331) 806-3939
NPI assigned
Oct 17, 2018
Last updated
Mar 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Authorized official

Name
Mrs. Margo Alena McCollister, LCPCNPI 1528345287
Title
Owner
Phone
(630) 664-1449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

212 S Main St
Wheaton, IL 60187-5232

Mailing address

616 N Lincoln Ave
Geneva, IL 60134-1218
Phone (630) 664-1449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241106003518 IL Part B Supplier - Clinic/Group Practice 3971037409 Receives reassigned benefits from 2 practitioners
Practice locations: Wheaton, IL

National Provider Directory

National Provider Directory

Locations

111 W Wesley St
Ste 2
Wheaton, IL 60187
Phone (630) 664-1449

212 S Main St
Wheaton, IL 60187
Phone (630) 373-5232

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1255807244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 N LINCOLN AVE",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601341218",
            "telephone_number": "630-664-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875232",
            "telephone_number": "630-664-1449",
            "fax_number": "331-806-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEATON WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "MCCOLLISTER",
        "authorized_official_first_name": "MARGO",
        "authorized_official_middle_name": "ALENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-664-1449",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.