Centegra Health and Wellness Network

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

CENTEGRA HEALTH AND WELLNESS NETWORK

Practice address

4209 W Shamrock LN
Suite B
McHenry, IL 60050-8700

Phone

(815) 759-8039

Fax

(815) 578-0636

NPI assigned

Aug 27, 2012

Organization subpart

No

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

Authorized official

Name

Julie A Keppler

Title

Director of Clinical Integration

Phone

(815) 759-8039

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1881942647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 W SHAMROCK LN",
            "address_2": "SUITE B",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508700",
            "telephone_number": "815-759-8039",
            "fax_number": "815-578-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 W SHAMROCK LN",
            "address_2": "SUITE B",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508700",
            "telephone_number": "815-759-8039",
            "fax_number": "815-578-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTEGRA HEALTH AND WELLNESS NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "KEPPLER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL INTEGRATION",
        "authorized_official_telephone_number": "815-759-8039"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stan Cebrzynski, LCPC
• Courtney Rhiannon Cecille
• Eleonora C Cekova, M.D.
• Nilubol Cencula, RPH
• Centegra Clinical Laboratories, LLC
• Centegra Health System
• Centegra Primary Care LLC
• Center for Therapeutic Services & Psychodiagnostics
• James Cerbes
• Juli Chaffee, MSW LSW

• Exclusive Provider Organization in McHenry, IL
• Providers in McHenry, IL by specialty
• Exclusive Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.