NPIMap

Organization Active NPI

Illinois Wellness Group of Joliet, LTD

  • General Practice Physician
  • Joliet, IL
National Provider Identifier
1215342829
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ILLINOIS WELLNESS GROUP OF JOLIET, LTD
Practice address
815 N Larkin Ave
Suite 105
Joliet, IL 60435-3438
Phone
(815) 714-2271
Fax
(815) 582-3262
NPI assigned
Jun 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Authorized official

Name
Dr. Brett Nolan Nash, D.C.NPI 1609043926
Title
Owner
Phone
(815) 714-2271

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

815 N Larkin Ave
Suite 105
Joliet, IL 60435-3438

Mailing address

815 N Larkin Ave
Suite 105
Joliet, IL 60435-3438
Phone (815) 714-2271

Other names 1

  • Joliet Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

815 N Larkin Ave
Ste 105
Joliet, IL 60435
Phone (815) 714-2271

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1215342829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N LARKIN AVE",
            "address_2": "SUITE 105",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353438",
            "telephone_number": "815-714-2271",
            "fax_number": "815-582-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N LARKIN AVE",
            "address_2": "SUITE 105",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353438",
            "telephone_number": "815-714-2271",
            "fax_number": "815-582-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS WELLNESS GROUP OF JOLIET, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "NASH",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "NOLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-714-2271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joliet Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.