Organization Active NPI

Evolve Healing and Wellness Center

  • Adult Mental Health Clinic/Center
  • Palatine, IL
National Provider Identifier
1841945870
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
EVOLVE HEALING AND WELLNESS CENTER
Practice address
579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102
Phone
(312) 945-7566
NPI assigned
Feb 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Dr. Kari Alysse Weiterschan, PHDNPI 1598438608
Title
Practice Owner/Manager
Phone
(312) 945-7566

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102

Mailing address

579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102
Phone (312) 945-7566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230831002774 IL Part B Supplier - Clinic/Group Practice 9931562352 Receives reassigned benefits from 1 practitioner
Practice locations: Palatine, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1841945870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 N 1ST BANK DR STE 150",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678102",
            "telephone_number": "312-945-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 N 1ST BANK DR STE 150",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678102",
            "telephone_number": "312-945-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE HEALING AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "WEITERSCHAN",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "ALYSSE",
        "authorized_official_title_or_position": "PRACTICE OWNER/MANAGER",
        "authorized_official_telephone_number": "312-945-7566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.