Active NPI
Jody A Weller
- Dentist
- Bloomingdale, IL
National Provider Identifier
1427219328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019020585
- Practice address
- 360 W Schick Rd Ste 17
Bloomingdale, IL 60108-2965 - Phone
- (708) 805-6565
- NPI assigned
- Jun 23, 2008
- Last updated
- Jan 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019020585 | IL | Primary |
Addresses
Primary practice location
360 W Schick Rd Ste 17
Bloomingdale, IL 60108-2965
Mailing address
PO Box 27046
Scottsdale, AZ 85255-0134
Phone (708) 805-6565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019020585 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1427219328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27046",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852550134",
"telephone_number": "708-805-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 W SCHICK RD STE 17",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082965",
"telephone_number": "708-805-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "JODY",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019020585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
- Debbie Jean Walton, RPH
- Brian Eugene Ward, M.D.
- Sean Warren, PT
- Danyale Washington
- Leah Lynn Weber, D.C.
- Wells Counseling, PLLC
- West Suburban Care Center, LLC
- West Suburban Nursing and Rehabilitation Center, LLC
- West Suburban Surgical Associates, LTD. (advanced breast care specialists)
- Jeffrey A. Whitis, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.