Provider Demographics
NPI:1144086752
Name:PSYCHIATRIC WELLNESS LLC
Entity type:Organization
Organization Name:PSYCHIATRIC WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALABAI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:630-309-4140
Mailing Address - Street 1:758 BUFFALO CIR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-9106
Mailing Address - Country:US
Mailing Address - Phone:630-309-4140
Mailing Address - Fax:
Practice Address - Street 1:4646 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1545
Practice Address - Country:US
Practice Address - Phone:815-416-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty