Edward Health Ventures

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EDWARD HEALTH VENTURES

Practice address

2855 W 95TH St
Naperville, IL 60564-9011

Phone

(630) 646-3950

Fax

(630) 548-6832

NPI assigned

Oct 12, 2012

Last updated

Oct 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bill Kottmann

Title

President

Phone

(630) 646-3950

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 9

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.

• Jeffrey Scott Bram, MSW, LCSW

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1679752943
  NPD
• Zaid Waleed Jabbar, M.D.

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1730351115
  NPD
• Lindsey Ann Lynch, PA-C

  • Physician Assistant
  • Bolingbrook, IL
  • NPI 1295965945
  NPD
• Katherine J O'Donnell, LCSW

  • Clinical Social Worker
  • Bolingbrook, IL
  • NPI 1558711580
  NPD
• Suzanne Oddo, APRN

  • Nurse Practitioner
  • Elmhurst, IL
  • NPI 1912512823
  NPD
• Dylan Michael Panuska, PSYD

  • Clinical Psychologist
  • Woodridge, IL
  • NPI 1841699220
  NPD
• Melissa Ann Peart, PAC

  • Physician Assistant
  • Lombard, IL
  • NPI 1609102631
  NPD
• Sarah KR Ringness, APN-CNP

  • Nurse Practitioner
  • Sugar Grove, IL
  • NPI 1730655309

  Family

  NPD
• Moses Godofredo Tomacruz, MD

  • Family Medicine Physician
  • Plainfield, IL
  • NPI 1144414921
  NPD

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1396097440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27555 DIEHL RD",
            "address_2": "ENTRANCE B",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553849",
            "telephone_number": "630-646-3950",
            "fax_number": "630-548-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 W 95TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649011",
            "telephone_number": "630-646-3950",
            "fax_number": "630-548-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD HEALTH VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "KOTTMANN",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-646-3950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures (Edward Medical Group)
• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures
• Edward Health Ventures

• Clinic/Center in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.