Active NPI
John Wesley, MD
- Pediatric Surgery Physician
- Vernon Hills, IL
National Provider Identifier
1124421680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 036094184
- Practice address
- 185 S Old Creek Rd
Vernon Hills, IL 60061-3134 - Phone
- (847) 821-8626
- NPI assigned
- Sep 29, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 036094184 | IL | Primary |
Addresses
Primary practice location
185 S Old Creek Rd
Vernon Hills, IL 60061-3134
Mailing address
185 S Old Creek Rd
Vernon Hills, IL 60061-3134
Phone (847) 821-8626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036094184 | IL | MD | Pediatric Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411948800000",
"number": "1124421680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 S OLD CREEK RD",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600613134",
"telephone_number": "847-821-8626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 S OLD CREEK RD",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600613134",
"telephone_number": "847-821-8626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESLEY",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-29",
"last_updated": "2014-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "IL",
"license": "036094184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.