Strivemd Wellness & Ketamine PLLC
Anesthesiology, Pain Medicine in Skokie, IL. Organization (NPI-2).
NPI number1336735562
StatusActive
Last updated in NPPESDec 11, 2020
Details
- NPI
- 1336735562
- Entity type
- Organization (NPI-2)
- Legal business name
- Strivemd Wellness & Ketamine PLLC
- Organization subpart
- No
- Enumeration date
- Dec 11, 2020
- Certification date
- Dec 11, 2020
- Last updated
- Dec 11, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207LP2900X | Anesthesiology, Pain Medicine | – | – | Yes |
Practice location
8707 Skokie Blvd Ste 307Skokie, IL 60077-2281
Phone 847-213-0990
Mailing address
8707 Skokie Blvd Ste 307Skokie, IL 60077-2281
Phone 847-213-0990
Authorized official
Danny Park
MD / Partner
4195093726
Is something wrong?
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