Wellness Medical Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLNESS MEDICAL CENTER LLC

Practice address

8937 W Golf Rd
Niles, IL 60714-5812

Phone

(248) 842-9353

NPI assigned

Mar 25, 2019

Organization subpart

No

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

Authorized official

Name

Olena Gordon, MDNPI 1528309705

Title

Owner/ Physician

Phone

(847) 375-9711

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olena Gordon, M.D.

  • Family Medicine Physician
  • Niles, IL
  • NPI 1528309705
  Medicare reassignment NPD Authorized official
• Svetlana Bielecki, APN

  • Adult Health Nurse Practitioner
  • Wheeling, IL
  • NPI 1134309982
  Medicare reassignment NPD

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1609336627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8937 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8937 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145812",
            "telephone_number": "248-842-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "OLENA",
        "authorized_official_title_or_position": "OWNER/ PHYSICIAN",
        "authorized_official_telephone_number": "847-375-9711",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036131766",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F100554988",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Waxberg Orthopedic Shoes Inc
• Katherine Wegrecki
• Lawrence K Weiner, M.D.
• Sherwin Weisman, BC-HIS
• Teresa Weiss
• Kristen Wendell, DO
• Matthew M Wessel, M.D.
• Beverly Wessels, LCSW
• John V White, MD
• Cheryl Wickrema, OTR

• Family Medicine Physician in Niles, IL
• Providers in Niles, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.