Wholehealth Chicago-3
Organization Active NPI Internal Medicine Physician · Chicago, IL
NPI 1487722666 · NPPES record last updated Jul 15, 2021
Key facts
- NPI
- 1487722666
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- WHOLEHEALTH CHICAGO-3
- Practice address
- 2522 N Lincoln Ave
Chicago, IL 60614-2352 - Phone
- (773) 296-6700
- Fax
- (773) 296-1131
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
Authorized official
- Name
- David Keith Edelberg, MD
- Title
- Secretary
- Phone
- (773) 296-6700
Practitioners 32
-
Jerry P Gore, M.D.
-
Mitchell A Katz, D.C.
-
Clifford Paul Maurer, D.C.
-
Eleanor Aisenberg, PSY. D.
-
Khalida A Anwar, MD
-
Frances Baxley, MD
-
Carol Gore, LCSW
-
Emily Januszewski, LPC
-
Robert John Wolf, M.D.
-
Richard A. Bisceglie, D.N.
-
Andrea Sue Clem, DO
-
Alisa Courtney, LCPC
-
Jennifer Davis, M.A.
-
Elda Duplessis, LMT
-
Richard A Feely, D.O.
-
Kristen Ann Halland, D.C.
-
Josh Hover, DC
-
Casey Kelley, MD
-
Cindy Kudelka, LAC, MSTOM
-
Alexis Larson, NP-C
-
Marta Lemesh, MSN, FNP-C
-
Jaclyn McGovern, DPT
-
Parisa Samsami, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080229000390 | IL | Part B Supplier - Clinic/Group Practice | 9335223247 |
Receives reassigned benefits from 3 practitioners Practice locations: Riverwoods, IL; Chicago, IL |
National Provider Directory
Locations
3237 W 111th St
Chicago, IL 60655
Phone (773) 238-4500
2265 N Clybourn Ave
#16
Chicago, IL 60614
2565 N Clybourn Ave
Chicago, IL 60614
82 W Saint Charles Rd
Unit B
Villa Park, IL 60181
214 N Hale St
Wheaton, IL 60187
Phone (630) 281-2444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | |||
| Chiropractor |
111N00000X | |||
| Nutritionist |
133N00000X | |||
| Acupuncturist |
171100000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Physical Therapist |
225100000X |
Addresses
Primary practice location
2522 N Lincoln Ave
Chicago, IL 60614-2352
Mailing address
2565 N Clybourn Ave
Chicago, IL 60614-3052
Phone (773) 296-6700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1623831 | Other | IL | BLUE CROSS BLUE SHIELD |
Other names
- WholeHealth Chicago 3 SC
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | wholehealthchicago.com |
Other providers in Chicago, IL
- Whole Health MD LLC
- Whole Healthcare & Co.
- Whole Hearted Psychotherapy LLC
- Whole Three Wellness, PLLC
- Whole You Healing PC
- Wholesale Trading Inc
- Wholistic Alliance
- Wholistic Approach Home Health Services, LLC
- Wholistic Home Health Care LLC
- Wholistic Inc.
All providers in Chicago, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.