Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fourcorners Wellness Center, Ltd

Organization Clinical Social Worker · NPI 1932968633

Fourcorners Wellness Center, Ltd is a Clinical Social Worker in Loves Park, Illinois. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4001 N Perryville Rd
Loves Park, IL 61111-8644
Phone: (815) 988-4370
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1932968633
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Polky — Founder/President · (815) 988-4370
NPI enumeratedMarch 15, 2024
Last updated in NPPESMarch 15, 2024
Certification dateMarch 15, 2024
Mailing address4001 N Perryville Rd, Loves Park, IL 61111-8644

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