Look up the most recent NPI and PECOS records

Dialogue To Wellness

(<Unavail>)

Social Worker

Behavioral Health & Social Service Providers

639 W Diversey Pkwy, Chicago, IL 60614-1501

PECOS Enrollment

Based on the most recent information from CMS, provider Dialogue To Wellness does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1417318916
Provider Type
Organization
Full Name
Dialogue To Wellness
Other Name
<Unavail>

Subpart
No
Enumeration Date
3/10/2016
Last Updated
9/27/2022

Contact Information

Practice Location

639 W Diversey Pkwy, Chicago, IL 60614-1501

(773) 312-5265

Unlisted Fax

Mailing Location

2920 N Commonwealth Ave, Chicago, IL 60657-6233

(773) 312-5265

Unlisted Fax

Authorized Official

Martinez, Jennifer Andrea (Manager/Member)

(312) 286-5215

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 149014238 Illinois

Dialogue To Wellness

(<Unavail>)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Mitchell, Yvette

Bagley, Lafayette R

Gardner, Brittany

Sancen, Silvia

Shapps, Kimberly J

Ladden, Indrig

Friedman, Tamar Blythe

Thorn, Stacey Ann

Mill, Kori C.

Witowski, Kaley Anne