NPIMap

Organization Active NPI

Wellbe Senior Medical Illinois PC

  • Internal Medicine Physician
  • Lisle, IL
National Provider Identifier
1306499363
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLBE SENIOR MEDICAL ILLINOIS PC
Practice address
550 Warrenville Rd Ste 300
Lisle, IL 60532-4311
Phone
(855) 490-5434
NPI assigned
Jul 18, 2019
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Iyad G. Houshan
Title
President
Phone
(312) 776-2415

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X

Addresses

Primary practice location

550 Warrenville Rd Ste 300
Lisle, IL 60532-4311

Mailing address

225 W Washington St Ste 1700
Chicago, IL 60606-3404
Phone (855) 490-5434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191010002358 IL Part B Supplier - Clinic/Group Practice 4486985199 Receives reassigned benefits from 32 practitioners
Practice locations: Lisle, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2233695Wellbe Senior Medical Illinois, PC550 Warrenville Rd, Suite 300, Lisle, IL 60532Certificate of waiverAug 5, 2026

National Provider Directory

National Provider Directory

Locations

225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (312) 463-4903

550 Warrenville Rd
Ste 200
Lisle, IL 60532
Phone (312) 776-2422

550 Warrenville Rd
Ste 300
Lisle, IL 60532
Phone (312) 212-3217

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1306499363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W WASHINGTON ST STE 1700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063404",
            "telephone_number": "855-490-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WARRENVILLE RD STE 300",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605324311",
            "telephone_number": "855-490-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBE SENIOR MEDICAL ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-18",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "HOUSHAN",
        "authorized_official_first_name": "IYAD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-776-2415"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.