Jeffrey A. Weller, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19020147 Issued in IL

Practice address

1050 N State St
Mezzanine Level
Chicago, IL 60610-7829

Phone

(312) 654-0606

Fax

(312) 654-1606

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jeffrey a. Weller, DDS, PC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1699839266
  NPD (past) Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497819023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N STATE ST",
            "address_2": "MEZZANINE LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107829",
            "telephone_number": "312-654-0606",
            "fax_number": "312-654-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N STATE ST",
            "address_2": "MEZZANINE LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107829",
            "telephone_number": "312-654-0606",
            "fax_number": "312-654-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19020147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellbe Senior Medical LLC
• Wellbe Utah LLC
• Wellbeing Chiropractic SC
• Wellcare Enterprises LLC
• Wellcare Health PLLC
• Katherine Grace Claudia Weller
• Stephanie M Weller, M.D.
• Jasmeen Wellere
• Mary Colleen Welles, APN
• Celeste Wellin, LCSW

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.