NPIMap

Organization Active NPI

Lotus Wellness Center P.C.

  • Mental Health Counselor
  • Palatine, IL
National Provider Identifier
1114450061
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180009919 Issued in IL
Legal business name
LOTUS WELLNESS CENTER P.C.
Practice address
1292 W Northwest Hwy
Palatine, IL 60067
Phone
(773) 592-7227
NPI assigned
Apr 7, 2017
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Leo Gerdov, D.C.NPI 1366760308
Title
Owner
Phone
(630) 988-5364

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180009919 IL Primary
Chiropractor 111N00000X 038011689 IL

Addresses

Primary practice location

1292 W Northwest Hwy
Palatine, IL 60067

Mailing address

638 Dunsten Cir
Northbrook, IL 60062-2613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170523000465 IL Part B Supplier - Clinic/Group Practice 8921375908 Receives reassigned benefits from 8 practitioners
Practice locations: Palatine, IL

National Provider Directory

National Provider Directory

Locations

1240 W Northwest Hwy
Palatine, IL 60067
Phone (773) 592-7227

1292 W Northwest Hwy
Palatine, IL 60067
Phone (630) 988-5364

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1114450061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 DUNSTEN CIR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1292 W NORTHWEST HWY",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "60067",
            "telephone_number": "773-592-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS WELLNESS CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "GERDOV",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-988-5364",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180009919",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.