Edward Health Ventures

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

EDWARD HEALTH VENTURES

Practice address

1025 Ogden Ave
Lisle, IL 60532-4388

Phone

(630) 515-1667

Fax

(630) 515-1825

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William G. Kottman

Title

President

Phone

(630) 646-3950

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Edward Medical Group Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Constantine Wonais, MD

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1457340267
  NPD

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238112000000",
    "number": "1174573109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27555 DIEHL RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553849",
            "telephone_number": "630-646-3950",
            "fax_number": "630-646-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 OGDEN AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605324388",
            "telephone_number": "630-515-1667",
            "fax_number": "630-515-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD HEALTH VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2009-03-27",
        "status": "A",
        "authorized_official_last_name": "KOTTMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-646-3950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2222543",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dupage Medical Group LTD
• Dupage Medical Group LTD
• Dupage Medical Group LTD
• Dupagedietitians
• Shanika M Eberhardt, FNP
• Edward Health Ventures
• Nancy Eiseman, M.D.
• Aniema Ekong
• Elevated Mind Counseling, LLC
• Diane Marie Ellig, NP-C

• Multi-Specialty Clinic/Center in Lisle, IL
• Providers in Lisle, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.