Welllife-A Subsidiary of Innovative Sustainable Solutions

NPI #1003196973 in Markham, Illinois

Provider Information

NPI Number: 1003196973
Entity Type: Organization
Organization Name: Welllife-A Subsidiary of Innovative Sustainable Solutions
Subpart: Yes (part of a larger organization)
Parent Organization: INNOVATIVE SUSTAINABLE SOLUTIONS
Primary Specialty: Community/Behavioral Health
Enumeration Date: Aug 24, 2011
Last Updated: Sep 1, 2011

Practice Location

Address: 15808 CLIFTON PARK AVE
City: Markham
State: Illinois
ZIP Code: 60428-3921
Phone: (773) 531-5163

Authorized Official

Name: MR. ANDRE MCCLERKLIN, MDIV
Title: CEO
Phone: (773) 531-5163

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X	Primary

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