PROACTIVE WELLNESS CENTER
NPI 1174664882
Nurse Practitioner in Libertyville, IL

Active since February 08, 2007
14044 W PETRONELLA DR, SUITE 3, LIBERTYVILLE, IL 60048(847) 549-6044(847) 549-6058 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Proactive Wellness Center NPPES

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

PROACTIVE WELLNESS CENTER (NPI 1174664882) is a healthcare organization registered as a nurse practitioner in Libertyville, Illinois and active in the NPI registry since February 2007. The organization lists Mary I Stowell, President, as its authorized official.

NPPES Registry Identity

NPI1174664882
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NamePROACTIVE ALTERNATIVES PC
Location Address14044 W PETRONELLA DR, SUITE 3Libertyville, IL 60048-9656
Mailing Address14044 W Petronella Dr, Suite 3Libertyville, IL 60048-9656 · (847) 549-6044 · Fax (847) 549-6058
Fax(847) 549-6058
Organization SubpartNo
Authorized OfficialMary I StowellPresident · (847) 549-6044
Enumeration DateFebruary 8, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1174664882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

14044 W PETRONELLA DR, Libertyville, IL 60048

Other Names 1

Doing Business AsProactive Wellness Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 for Provider-Performed Microscopy Procedures (PPMP) 14D0992335

Proactive Wellness Center · Libertyville, IL
Expired · Oct 14, 2025
CLIA Number14D0992335
Laboratory TypePractitioner Other
Certificate Effective DateOctober 15, 2023
Certificate Expiration DateOctober 14, 2025
Laboratory DirectorMary Stowell
Laboratory Phone(847) 549-6044
Laboratory LocationProactive Wellness Center14044 Petronella Drive, Suite 3, Libertyville, IL 60048
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174664882, enumerated as an "organization" on February 08, 2007.

The provider is located at 14044 W PETRONELLA DR SUITE 3 LIBERTYVILLE, IL 60048 and the phone number is (847) 549-6044.

Nurse Practitioner with taxonomy code 363L00000X.