Individual provider Active NPI

Adam Joseph Weldzius, ACNP-BC

  • Primary Care Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1477793792
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
277000313 Issued in IL
Practice address
15614 S Harlem Ave Ste C
Orland Park, IL 60462-4401
Phone
(708) 866-5900
Fax
(708) 866-5903
NPI assigned
Feb 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 277000313 IL Primary

Addresses

Primary practice location

15614 S Harlem Ave Ste C
Orland Park, IL 60462-4401

Mailing address

15614 S Harlem Ave Ste C
Orland Park, IL 60462-4401
Phone (708) 866-5900

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
I20100301000838 IL Practitioner - Nurse Practitioner 0345385480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16533 106TH CT
Orland Park, IL 60467-4522
Phone (708) 866-5900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277000313ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Live Ignite Thrive Limited CurrentSince Oct 1, 2020 Accepting new patients
Chicagoland Internal Medicine LLC Past Accepting new patients
Mens Health Lasalle LLC Past Accepting new patients

Locations

15614 S Harlem Ave
Ste C
Orland Park, IL 60462
Phone (708) 866-5900

16533 106th Ct
Orland Park, IL 60467
Phone (708) 364-7380

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1477793792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15614 S HARLEM AVE STE C",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624401",
            "telephone_number": "708-866-5900",
            "fax_number": "708-866-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15614 S HARLEM AVE STE C",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624401",
            "telephone_number": "708-866-5900",
            "fax_number": "708-866-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDZIUS",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "277000313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.