Provider Demographics
NPI:1063795763
Name:SEDONA CENTER FOR WELL BEING P.C.
Entity type:Organization
Organization Name:SEDONA CENTER FOR WELL BEING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-550-6929
Mailing Address - Street 1:311 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2863
Mailing Address - Country:US
Mailing Address - Phone:630-797-5133
Mailing Address - Fax:630-549-1019
Practice Address - Street 1:311 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2863
Practice Address - Country:US
Practice Address - Phone:630-797-5133
Practice Address - Fax:630-549-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490062131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty