Individual provider Active NPI

Selam Zewdie Bedada, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1104705508
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209031849 Issued in IL
Practice address
143000 Ravinia Ave
Suite 100
Orland Park, IL 60462
Phone
(708) 778-3779
NPI assigned
Aug 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209031849 IL Primary

Addresses

Primary practice location

143000 Ravinia Ave
Suite 100
Orland Park, IL 60462

Mailing address

7250 N Claremont Ave
Chicago, IL 60645-1804
Phone (702) 265-7597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007002225 IL Practitioner - Nurse Practitioner 1951808948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMS Clinical Services PLLCGroup PAC ID 7517395064, 30 clinicians

Practice addresses (Care Compare)

14300 S Ravinia Ave
Suite 100
Orland Park, IL 60462-2578
Phone (630) 974-6602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209031849ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMS Clinical Services PLLC CurrentSince Aug 18, 2025 Accepting new patients

Locations

1100 Jorie Blvd
Ste 300
Oak Brook, IL 60523
Phone (224) 900-7867

14300 S Ravinia Ave
Ste 100
Orland Park, IL 60462
Phone (855) 205-4764

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1104705508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 N CLAREMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451804",
            "telephone_number": "702-265-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143000 RAVINIA AVE",
            "address_2": "SUITE 100",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60462",
            "telephone_number": "708-778-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDADA",
        "first_name": "SELAM",
        "middle_name": "ZEWDIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209031849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.