Maysah Ehealth & Wellness LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MAYSAH EHEALTH & WELLNESS LLC

Practice address

310 N Hammes Ave Ste 300B
Joliet, IL 60435-7661

Phone

(815) 714-9933

Fax

(949) 695-3321

NPI assigned

Jan 8, 2024

Organization subpart

No

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

Authorized official

Name

Mutengwana Kasapu-Mwaba, FNPNPI 1619480696

Title

Owner

Phone

(678) 559-5065

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mutengwana Kasapu-Mwaba

  • Family Nurse Practitioner
  • Joliet, IL
  • NPI 1619480696
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1497525679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21349 WESTMINSTER LN",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604042501",
            "telephone_number": "815-714-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N HAMMES AVE STE 300B",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604357661",
            "telephone_number": "815-714-9933",
            "fax_number": "949-695-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYSAH EHEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "KASAPU-MWABA",
        "authorized_official_first_name": "MUTENGWANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-559-5065",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Anne Matys, M,S.
• Kristen Mau, FNP-C
• Thomas J. Maurice, D.D.S., M.S.
• Maxident LLC
• Ashley M Mayer
• Jasmine Mazique, PTA
• Chandra McCain, LICENSED COUNSELOR
• Erin Kathleen McCarthy, MOT, OTRL
• Sheila McCarthy
• Ronald Edward McCaslin Jr., PMHNP-BC

• Family Nurse Practitioner in Joliet, IL
• Providers in Joliet, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.