Wholehealth Chicago-3

Primary specialty

Internal Medicine PhysicianTaxonomy code 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

Last updated

Jul 15, 2021By 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

David Keith Edelberg, MDNPI 1780809764

Title

Secretary

Phone

(773) 296-6700

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• WholeHealth Chicago 3 SC Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 33

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.

• Jerry P Gore, M.D.

  • General Practice Physician
  • Riverwoods, IL
  • NPI 1972695633
  Medicare reassignment NPD
• Mitchell A Katz, D.C.

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1407929573

  IL

  Medicare reassignment NPD
• Clifford Paul Maurer, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1558694463
  Medicare reassignment
• David Keith Edelberg, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1780809764
  Authorized official Same address or phone
• Eleanor Aisenberg, PSY. D.

  • Clinical Psychologist
  • Skokie, IL
  • NPI 1033218649
  NPD
• Khalida A Anwar, MD

  • Physical Medicine & Rehabilitation Physician
  • Glenview, IL
  • NPI 1952384117
  NPD
• Frances Baxley, MD

  • Family Medicine Physician
  • Lake Forest, IL
  • NPI 1730389685
  NPD
• Carol Gore, LCSW

  • Social Worker
  • Riverwoods, IL
  • NPI 1154413987
  NPD
• Emily Januszewski, LPC

  • Mental Health Counselor
  • Riverwoods, IL
  • NPI 1043913940
  NPD
• Robert John Wolf, M.D.

  • Internal Medicine Physician
  • Riverwoods, IL
  • NPI 1376566034
  NPD
• Richard A. Bisceglie, D.N.

  • Naprapath
  • Riverwoods, IL
  • NPI 1982737813
  NPD (past)
• Andrea Sue Clem, DO

  • Family Medicine Physician
  • McHenry, IL
  • NPI 1770541369
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1487722666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143052",
            "telephone_number": "773-296-6700",
            "fax_number": "773-296-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142352",
            "telephone_number": "773-296-6700",
            "fax_number": "773-296-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLEHEALTH CHICAGO-3",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "EDELBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "773-296-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1623831",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wholehealthchicago.com",
            "affiliation": "N",
            "address_1": "2265 N Clybourn Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606143052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WholeHealth Chicago 3 SC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WholeHealth Chicago 3 SC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• 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.

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.