GLOW HEALTH AND WELLNESS MEDICAL SPA, PC (NPI# 1205345337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205345337 |
| Entity Type | Organization |
| Organization Name | GLOW HEALTH AND WELLNESS MEDICAL SPA, PC |
| Practice Address |
1528 W Monroe St Ste 100 Chicago IL 60607-2460 |
| Mailing Address |
1001 W 15th St Unit 320 Chicago IL 60608-2778 |
| Practice Telephone | 6309012879 |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2017-09-20 |
| Authorized Official Name | MS. TAJUANA D. JOHNSON (OWNER, MANAGER) |
| Authorized Official Telephone | 6309012879 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QI0500X |
Clinic/Center Specialization: Infusion Therapy |
209008594 | IL | Ambulatory Health Care Facilities |
| Y | 261Q00000X | Clinic/Center | 209008594 | IL | Ambulatory Health Care Facilities |
| Street Address |
1528 W MONROE ST STE 100 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60607-2460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992349237 | Portia Dowd | Registered Nurse | 140 N Ashland, Chicago, IL 60607 | 2019-10-30 |
| 1114577210 | Joseph Matthew Thiel | Emergency Medical Technician, Intermediate | 558 West De Koven, Chicago, IL 60607 | 2019-09-19 |
| 1215585757 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1034 West Lake St, Chicago, IL 60607 | 2019-08-28 |
| 1003462821 | Michael Marek Maka | Psychologist | 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 | 2019-08-16 |
| 1558922344 | Kellie Meyer | Speech-Language Pathologist | Eyas Landing West Loop, 1409 W. Carroll Ave, Chicago, IL 60607 | 2019-06-24 |
| 1811460108 | Corinna House | Social Worker | 932 W Washington, Chicago, IL 60607 | 2019-01-09 |
| 1962979518 | Louise Taussig Bush | Counselor | 1142 West Madison Street, Suite 406, Chicago, IL 60607 | 2018-10-31 |
| 1568941318 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1051 W Randolph, Chicago, IL 60607 | 2018-08-13 |
| 1851883425 | Alefiyah Zulfiqar Pishori | Psychologist | 1200 West Harrison St, Chicago, IL 60607 | 2018-05-30 |
| 1679062954 | Elizabeth R Rolston | Physical Therapist | 24 S Morgan St Ste 100, Chicago, IL 60607 | 2018-05-02 |
| Find all providers in zip 60607 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1649817768 | Rising Root Nutrition LLC | Clinic/Center | 2835 N Sheffield Ave Ste 511, Chicago, IL 60657-5081 | 2019-12-09 |
| 1487203642 | Jennifer Scherbauer | Clinic/Center | 4036 N Ashland Ave Apt 1w, Chicago, IL 60613-2534 | 2019-09-10 |
| 1194380147 | Colmed Clinic Ltd | Clinic/Center | 3615 N Ashland Ave Apt 1n, Chicago, IL 60613-4742 | 2019-05-06 |
| 1831662931 | Ova Institute LLC | Clinic/Center | 401 N Michigan Ave Ste 1800, Chicago, IL 60611-4225 | 2019-01-10 |
| 1972080992 | Family Care Sc | Clinic/Center | 2320 W Peterson Ave Fl 6, Chicago, IL 60659-5242 | 2018-07-23 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.