OrganizationActive
Prescriptive Wellness LLC
NPI 1598920977 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Hazel Crest, IL
Provider details
- NPI number
- 1598920977
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Carla Watson, MD(773) 404-0160
- License
- 036106614 (IL)
Specialties & taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081S0010XLicense 036106614 (IL)
Allopathic & Osteopathic Physicians
Practice location
3330 W 177th St Ste 3f
Hazel Crest, IL 60429-2197
Phone: (773) 404-0160
Approximate (ZIP-level) locationGet directions
Mailing address
3330 W 177th St Ste 3f
Hazel Crest, IL 60429-2197
Registry dates
- Enumerated
- 2008-07-24
- Last updated
- 2009-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.