Organization Active NPI

Andrew Wahl and Ada Paolucci

  • Podiatrist
  • Joliet, IL
National Provider Identifier
1245418847
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ANDREW WAHL AND ADA PAOLUCCI
Practice address
1960 Essington Rd
Ste 103
Joliet, IL 60435-1617
Phone
(815) 436-3555
Fax
(815) 436-3578
NPI assigned
Feb 6, 2008
Last updated
Feb 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Authorized official

Name
Dr. Ada Vera Paolucci, DPMNPI 1063579472
Title
Owner
Phone
(815) 436-3555

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
Podiatrist 213E00000X IL Primary
Podiatrist 213E00000X 0016004462 IL

Addresses

Primary practice location

1960 Essington Rd
Ste 103
Joliet, IL 60435-1617

Mailing address

1960 Essington Rd
Ste 103
Joliet, IL 60435-1617
Phone (815) 436-3555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100708000355 IL Part B Supplier - Clinic/Group Practice 5991836934 Receives reassigned benefits from 2 practitioners
Practice locations: Joliet, IL

National Provider Directory

National Provider Directory

Locations

1960 Essington Rd
Ste 103
Joliet, IL 60435
Phone (815) 435-3555

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1245418847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 ESSINGTON RD",
            "address_2": "STE 103",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351617",
            "telephone_number": "815-436-3555",
            "fax_number": "815-436-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 ESSINGTON RD",
            "address_2": "STE 103",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351617",
            "telephone_number": "815-436-3555",
            "fax_number": "815-436-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW WAHL AND ADA PAOLUCCI",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "PAOLUCCI",
        "authorized_official_first_name": "ADA",
        "authorized_official_middle_name": "VERA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-436-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "0016004462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 6, 2008; 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.