ABRAHAM'S MARK COMPREHENSIVE WELLNESS CENTER, SC
NPI 1104857341
Clinic/Center - Primary Care in Chicago, IL

Q: What is Abraham's Mark Comprehensive Wellness Center, Sc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since July 05, 2006CLIA 14D0983271 · Waiver

9500 S DORCHESTER AVE, STE 100, CHICAGO, IL 60628(773) 667-0768(773) 667-5529 Get Directions Write a Review

NPPES record last updated: March 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 29, 2026, Dec 3, 2020 (2 updates tracked since 2020).

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About Abraham's Mark Comprehensive Wellness Center, Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ABRAHAM'S MARK COMPREHENSIVE WELLNESS CENTER, SC (NPI 1104857341) is a healthcare organization registered as a primary care in Chicago, Illinois and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 20, 2027 and lists Nicole D. King, Owner, as its authorized official.

NPPES Registry Identity

NPI1104857341

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameABRAHAM'S MARK COMPREHENSIVE WELLNESS CENTER, SC

Location Address9500 S DORCHESTER AVE, STE 100Chicago, IL 60628-1700

Mailing AddressPo Box 13677Belfast, ME 04915-4027 · (773) 667-0768 · Fax (773) 667-5529

Phone(773) 667-0768

Fax(773) 667-5529

Organization SubpartNo

Authorized OfficialNicole D. KingOwner · (773) 667-0768

Enumeration DateJuly 5, 2006

Last NPPES UpdateMarch 29, 20262 updates tracked since enumeration

NPPES CertifiedMarch 29, 2026

✔ NPI 1104857341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

License✔ Licensed in IL · 036096686

Also ListedFamily MedicineTaxonomy 207Q00000X

9500 S DORCHESTER AVE, Chicago, IL 60628

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Other Identifiers 6

Other1634166IL · Bc/bs

Other7455146IL · Cigna

Other7779286IL · Aetna Ppo

Other0061621IL · Tricare

Other3474878IL · Aetna Hmo

OtherDD6694IL · Railraod Medicare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0983271

Abrahams Mark Comprehensive Wellness Center · Chicago, IL

Active · expires Feb 20, 2027

CLIA Number14D0983271

Laboratory TypeCommunity Clinic

Certificate Effective DateFebruary 21, 2025

Certificate Expiration DateFebruary 20, 2027

Laboratory DirectorNicole D. King MD

Laboratory Phone(773) 667-0768

Laboratory LocationAbrahams Mark Comprehensive Wellness Center9500 S Dorcherster Ave, Ste 100, Chicago, IL 60628

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE D KING MD

Internal Medicine

9500 S DORCHESTER AVE, SUITE 100
CHICAGO, IL 60628

Cook County (773) 667-0768

JEFFREEMAN BROWN JR.

Massage Therapist

9500 S DORCHESTER AVE
CHICAGO, IL 60628

Cook County (773) 667-0768

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Abraham's Mark Comprehensive Wellness Center, Sc's NPI number?

The NPI number for Abraham's Mark Comprehensive Wellness Center, Sc is 1104857341. It was assigned to this organization in the NPPES registry on July 5, 2006.

Where is Abraham's Mark Comprehensive Wellness Center, Sc located?

Abraham's Mark Comprehensive Wellness Center, Sc is located at 9500 S Dorchester Ave Ste 100, Chicago, IL 60628. The listed phone number is (773) 667-0768.

What is Abraham's Mark Comprehensive Wellness Center, Sc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Abraham's Mark Comprehensive Wellness Center, Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0983271) is associated with this NPI, valid through February 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Abraham's Mark Comprehensive Wellness Center, Sc was last updated on March 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.