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

Supreme Wellness Aesthetics & Recovery Inc

Organization Emergency Medicine Physician · NPI 1275105967

Supreme Wellness Aesthetics & Recovery Inc is an Emergency Medicine Physician in Park Ridge, Illinois. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

678 N Northwest Hwy Ste C
Park Ridge, IL 60068-2540
Phone: (847) 653-6191
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X

Record details

NPI number1275105967
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dominika Pavone — Owner · (630) 635-6633
NPI enumeratedJuly 13, 2021
Last updated in NPPESAugust 5, 2021
Certification dateAugust 5, 2021
Mailing address678 N Northwest Hwy Ste C, Park Ridge, IL 60068-2540

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