Edwin S Chelli, M.D. – Adult Medicine Physician

Key facts

NPI: 1508988353
Entity type: Individual (NPI type 1)
Primary specialty: Adult Medicine Physician 207QA0505X
License: 37525 (SC)
Practice address: 289 Ireland Ave
Fort Knox, KY 40121-5111
Phone: (812) 526-1135
Fax: (812) 526-1768
NPI assigned: Apr 4, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 5

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.

American Current Care PA Urgent Care Clinic/Center · Addison, TX · NPI 1962680454

Medicare reassignment NPD SC
Ida County Iowa Community Hospital Critical Access Hospital · Ida Grove, IA · NPI 1265461180

Medicare reassignment NPD IA
The Finley Hospital Family Medicine Physician · Dubuque, IA · NPI 1073560462

Medicare reassignment NPD FAMILY MEDICINE · IA
American Current Care P.a. Urgent Care Clinic/Center · Beaumont, TX · NPI 1376356568

NPD
The Finley Hospital Emergency Medicine Physician · Dubuque, IA · NPI 1134176308

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in SC, IA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20151014003100	SC	Practitioner - Family Practice	9830221605	Reassigns benefits to 1 organization
I20201211001728	IA	Practitioner - Family Practice	9830221605	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
036-111266	IL	MD	Family Medicine Physician
37525	SC	MD	Adult Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
American Current Care PA		Current since Sep 12, 2024	Accepting new patients
The Finley Hospital		Current since Nov 2, 2020	Accepting new patients
The Finley Hospital	Family Medicine	Current	Accepting new patients
Ida County Iowa Community Hospital		Current	Accepting new patients
American Current Care P.a.		Current since Sep 12, 2024	Accepting new patients

Locations

350 N Grandview Ave
Dubuque, IA 52001
Phone (563) 582-1881

701 E 2nd St
Ida Grove, IA 51445
Phone (712) 364-3311

1230 W Lake St
Chicago, IL 60607
Phone (312) 666-0028

10137 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-7590

555 Valley View Dr
Moline, IL 61265
Phone (309) 764-9675

4115 Dorchester Rd
Ste 100
North Charleston, SC 29405
Phone (843) 554-6737

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	036-111266	IL
Family Medicine Physician	207Q00000X	430-10-72926	MI
Adult Medicine Physician	207QA0505X	37525	SC	Yes

Addresses

Primary practice location

289 Ireland Ave
Fort Knox, KY 40121-5111

Mailing address

9 Wishing Well CT
Simpsonville, SC 29681-4963
Phone (630) 363-5065

Other providers in Fort Knox, KY

All providers in Fort Knox, KY · Adult Medicine Physician in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2016. 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.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.