National Provider Identifier Database

AFFINITY FAMILY HEALTH AND WELLNESS PLLC
Family


Contact Information

AFFINITY FAMILY HEALTH AND WELLNESS, PLLC
1108 N EAST ST
OLNEY, IL62450-2462
Phone: 618-429-9470
Fax: 833-944-2035
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for AFFINITY FAMILY HEALTH AND WELLNESS, PLLC

NPI Number 1568938090
Legal business name
LBN
AFFINITY FAMILY HEALTH AND WELLNESS, PLLC
Authorized official JAMEE BALTZELL - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/23/2018
Last updated 12/22/2022 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • IL Medicaid: 0001568938090
  • IL Medicaid: 325765630001
  • IL Medicaid: 351725028001

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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