| Organization Name: | TRAVELWELL LLC |
| NPI Number: | 1053518787 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRACEY I MCLOONE (MEDICAL DIRECTOR) |
| Mailing Address: | 515 Valley View Dr Suite 103 Moline |
| State: | IL US |
| Postal Code: | 612656175 |
| Phone Number: | 3097571252 |
| Fax Number: | 3097577398 |
| NPI Enumeration Date: | 06/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 36096406 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |