BRAIN AND WELLNESS INSTITUTE LLC (NPI# 1942702386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942702386 |
| Entity Type | Organization |
| Organization Name | BRAIN AND WELLNESS INSTITUTE LLC |
| Practice Address |
30 W Oak St Apt 14a Chicago IL 60610-8724 |
| Practice Telephone | 3126368671 |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |
| Authorized Official Name | DR. NAGAMANI PAVULURI (OWNER) |
| Authorized Official Telephone | 3126368671 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
036101082 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
30 W OAK ST APT 14A |
| City | CHICAGO |
| State | IL |
| Zip Code | 60610-8724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326683145 | Roslyn M Jordan | Counselor | 860 N. Lasalle, Chicago, IL 60610 | 2019-11-15 |
| 1992278196 | Deangela Roberson | Specialist/Technologist, Other | 1212 N. Lasalle, Ste 100/ Surgery Center, Chicago, IL 60610 | 2019-01-10 |
| 1477053205 | Terri Lynn Tyson | Counselor | 1250 N. Dearborn St., 18b, Chicago, IL 60610 | 2018-02-19 |
| 1487153797 | Jennifer Quinn | Social Worker | 1200 N. Lasalle Street, Chicago, IL 60610 | 2018-02-02 |
| 1811415334 | Erin Conroy | Behavioral Analyst | 1400 North Lake Shore Drive Apt 8a, Chicago, IL 60610 | 2017-09-05 |
| 1659898674 | Courtney Jane Busing | Speech-Language Pathologist | 1211 N Lasalle, 903, Chicago, IL 60610 | 2017-08-30 |
| 1528503042 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 908 North State Street, Chicago, IL 60610 | 2016-12-20 |
| 1548702814 | Melissa Snyder | Counselor | 1820 N Lasalle Blvd, Counseling- Sweeting, Chicago, IL 60610 | 2016-11-17 |
| 1982146908 | Samantha Ruth Slagh | Physical Therapist | 1100 N Lasalle Street, Apt 1018, Chicago, IL 60610 | 2016-11-08 |
| 1891242426 | Stephanie Pinsler | Counselor | 100 W Chestnut, #1907, Chicago, IL 60610 | 2016-09-01 |
| Find all providers in zip 60610 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144851684 | Greywood Health Center LLC | Psychiatry & Neurology | 303 W Institute Pl Fl 3, Chicago, IL 60610-3080 | 2020-02-03 |
| 1598278749 | Elemental Treatment Center Ltd | Psychiatry & Neurology | 612 S Western Ave Apt 1, Chicago, IL 60612-4682 | 2017-11-09 |
| 1487032082 | Jerry Francisco Benzl | Psychiatry & Neurology | 1740 Taylor St., Chicago, IL 60612 | 2015-05-14 |
| 1326372780 | Syiha Ltd | Psychiatry & Neurology | 6321 N Leavitt, Apt 1n, Chicago, IL 60659 | 2009-10-01 |
| 1568514263 | Robert Elliot Blaik | Psychiatry & Neurology | 1642 E. 56th St., #505, Chicago, IL 60637-1973 | 2007-01-16 |
| 1891865515 | Mina K. Dulcan | Psychiatry & Neurology | 225 East Chicago Ave. Box 10, Ann & Robert H. Lurie Childrens Hospital of Chicago, Chicago, IL 60611-2605 | 2006-11-09 |
| 1124198239 | Thomas K. Cummins | Psychiatry & Neurology | 225 E Chicago Ave # 10, Chicago, IL 60611-2605 | 2006-11-08 |
| 1801994769 | Peter D Nierman | Psychiatry & Neurology | 3730 North Lake Shore Drive, #15a, Chicago, IL 60613 | 2006-09-21 |
| 1578661781 | Adrienne L. Adams | Psychiatry & Neurology | 1720 W Polk St, Mfiv- Child Psychiatry, Chicago, IL 60612-4328 | 2006-09-20 |
| 1497767719 | Elizabeth Charney | Psychiatry & Neurology | 1747 W Roosevelt Rd, Chicago, IL 60608-1264 | 2006-08-13 |
| 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.