Illuminated Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ILLUMINATED WELLNESS

Practice address

512 W Maywood Ave
Peoria, IL 61604-2838

Phone

(319) 504-5698

NPI assigned

Dec 21, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Zeck, LCSWNPI 1154845089

Title

Owner

Phone

(319) 504-5698

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Jennifer Zeck, LCSW

  • Clinical Social Worker
  • Peoria, IL
  • NPI 1154845089
  NPD Authorized official

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1639881642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W MAYWOOD AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616042838",
            "telephone_number": "319-504-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 W MAYWOOD AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616042838",
            "telephone_number": "319-504-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATED WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "ZECK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-504-5698",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://illuminatedwellness.clientsecure.me",
            "affiliation": "N",
            "endpointDescription": "Simple Practice",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "512 W Maywood Ave",
            "city": "Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616042838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Illinois Women's Health Center
• In-Home Physical Therapy
• Rosemary Ince
• Thad Indermuhle
• Thomas F Ingersoll, MD
• Natalie Christine Ingle, APRN NNP-BC

• Clinical Social Worker in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.