Provider Demographics
NPI:1215499884
Name:ESSENTIAL HEALTH PARTNERS, LLC
Entity type:Organization
Organization Name:ESSENTIAL HEALTH PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:KIRSTON
Authorized Official - Last Name:VAN WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:815-496-6004
Mailing Address - Street 1:814 COMMERCE DR STE 350
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1965
Mailing Address - Country:US
Mailing Address - Phone:815-496-6004
Mailing Address - Fax:
Practice Address - Street 1:814 COMMERCE DR STE 350
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1965
Practice Address - Country:US
Practice Address - Phone:815-496-6004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization