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Contact Information

ADDICTION WELLNESS SERVICES INC
5504 N 2ND ST
LOVES PARK, IL61111-5013
 Phone: 815-997-4516
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Anesthesiology

207LP3000X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for ADDICTION WELLNESS SERVICES INC

NPI # 1467966853
LBN Legal business name ADDICTION WELLNESS SERVICES INC
Authorized official GAGANDEEP GOYAL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/22/2017
Last updated 01/29/2019 - About 7 years ago
Identifiers
PA License # MD438154
IL Other 036144684 IL LICENSE
PA Other MD438154 PA LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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