Organization Active NPI

Wellcare Health PLLC

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1225757032
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLCARE HEALTH PLLC
Practice address
2553 W Peterson Ave
Chicago, IL 60659-4019
Phone
(773) 784-1025
Fax
(773) 784-1056
NPI assigned
Aug 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Kareem M Syed Shah
Title
Manager
Phone
(630) 748-9407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2553 W Peterson Ave
Chicago, IL 60659-4019

Mailing address

2553 W Peterson Ave
Chicago, IL 60659-4019
Phone (773) 784-1025

Other names 1

  • WellCare Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250429000616 IL Part B Supplier - Clinic/Group Practice 1658897095 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

2553 W Peterson Ave
Chicago, IL 60659
Phone (773) 784-1025

Practitioners & affiliated clinicians

Practitioners 7

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": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1225757032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594019",
            "telephone_number": "773-784-1025",
            "fax_number": "773-784-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2553 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594019",
            "telephone_number": "773-784-1025",
            "fax_number": "773-784-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "SYED SHAH",
        "authorized_official_first_name": "KAREEM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-748-9407"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellCare Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellCare Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.