Provider Demographics
NPI:1386826733
Name:FAMILY WELLNESS & HEALTHCARE, LLC.
Entity type:Organization
Organization Name:FAMILY WELLNESS & HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-464-9655
Mailing Address - Street 1:10289 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1279
Mailing Address - Country:US
Mailing Address - Phone:815-464-9655
Mailing Address - Fax:
Practice Address - Street 1:10289 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1279
Practice Address - Country:US
Practice Address - Phone:815-464-9655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-085569207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2022817945OtherMULTIPLAN
IL2022817945OtherUNICARE PROVIDER NUMBER
IL2022817945OtherINTERPLAN/PREFERRED PLAN
IL12650OtherHFN
IL212254OtherMEDICARE ID
IL776241OtherFIRST HEALTH
IL09932351OtherBCBS PROVIDER NUMBER
IL4398541OtherAETNA
IL2022817945OtherUNITED HEALTHCARE NUMBER
IL8025898OtherCIGNA PROVIDER NUMBER
IL9395998OtherPHCS
IL9395998OtherPHCS