Provider Demographics
NPI:1356125728
Name:ENVISION PELVIC HEALTH & WELLNESS PLLC
Entity type:Organization
Organization Name:ENVISION PELVIC HEALTH & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:872-294-4972
Mailing Address - Street 1:6323 N AVONDALE AVE STE B-110
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6323 N AVONDALE AVE STE B-110
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1962
Practice Address - Country:US
Practice Address - Phone:872-294-4972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy