Great Lakes Health & Wellness,SC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREAT LAKES HEALTH & WELLNESS,SC

Practice address

7250 W College Dr Ste 1SW
Palos Heights, IL 60463-1393

Phone

(708) 371-6114

Fax

(708) 371-0816

NPI assigned

Jul 1, 2008

Organization subpart

No

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

Authorized official

Name

Mary Peterson, DCNPI 1538233176

Title

President

Phone

(708) 574-0736

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

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

• Mary Peterson, D.C.

  • Chiropractor
  • Palos Heights, IL
  • NPI 1538233176
  Medicare reassignment NPD Authorized official
• Katie S King, D.C.

  • Chiropractor
  • West Dundee, IL
  • NPI 1295910354
  NPD (past)
• Natalie Martinez, D.C.

  • Chiropractor
  • Oak Park, IL
  • NPI 1144574559
  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1831351873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 W COLLEGE DR STE 1SW",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631393",
            "telephone_number": "708-371-6114",
            "fax_number": "708-371-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 W COLLEGE DR STE 1SW",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631393",
            "telephone_number": "708-371-6114",
            "fax_number": "708-371-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES HEALTH & WELLNESS,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-574-0736",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.008605",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "038.008605",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen A Graney, LCPC
• Granny'S Blessings Homecare Services, Inc.
• Calvin Alexander Grant, M.D.
• Jeanine Marie Grant, LPC
• Bozana Grbic, OT
• Jalessia Lyray Green, PA-C
• Breanne Gremillion, PSYD
• Vytenis T Grybauskas, M.D.
• Gisselle Guingon
• Pavan K Gupta, DO

• Durable Medical Equipment & Medical Supplies in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.