Provider Demographics
NPI:1962772996
Name:ZALWANGO HEALTH& WELLNESS CONCIERGE PC
Entity type:Organization
Organization Name:ZALWANGO HEALTH& WELLNESS CONCIERGE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:MADTURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALWANGO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:312-217-4671
Mailing Address - Street 1:8610 PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2282
Mailing Address - Country:US
Mailing Address - Phone:872-600-5700
Mailing Address - Fax:
Practice Address - Street 1:5250 OLD ORCHARD RD STE 300
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4462
Practice Address - Country:US
Practice Address - Phone:877-506-9955
Practice Address - Fax:855-734-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty