Individual provider Active NPI

Kalani Raquel Wells, APN

  • Nurse Practitioner
  • Palos Heights, IL
National Provider Identifier
1417214222
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277.001986 Issued in IL
Practice address
11824 Southwest Hwy
Ste 100
Palos Heights, IL 60463-1055
Phone
(708) 361-0222
Fax
(708) 361-4536
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209009509 IL
Nurse Practitioner 363L00000X 277.001986 IL Primary

Addresses

Primary practice location

11824 Southwest Hwy
Ste 100
Palos Heights, IL 60463-1055

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL http://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTu2 Health Information Exchange (HIE)
Direct Messaging Address kwells204926@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120804000089 IL Practitioner - Nurse Practitioner 8628224896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, shared by 39 NPIs, 3,081 clinicians

Practice addresses (Care Compare)

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277.001986ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation CurrentSince Aug 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

28592 Network Pl
Chicago, IL 60673

4440 W 95th St
Ste Aip
Oak Lawn, IL 60453
Phone (708) 684-8000

4400 W 95th St
Ste 407
Oak Lawn, IL 60453
Phone (708) 346-4062

11824 Southwest Hwy
Ste 100
Palos Heights, IL 60463
Phone (708) 361-0222

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1417214222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11824 SOUTHWEST HWY",
            "address_2": "STE 100",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631055",
            "telephone_number": "708-361-0222",
            "fax_number": "708-361-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KALANI",
        "middle_name": "RAQUEL",
        "name_prefix": "Miss",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209009509",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277.001986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "http://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTu2",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "11824 Southwest Hwy",
            "address_2": "Ste 100",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604631055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwells204926@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "11824 Southwest Hwy",
            "address_2": "Ste 100",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604631055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.