Sophia E Welykyj, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036069455 Issued in IL

Practice address

7234 Ogden Ave
Suite 1S
Riverside, IL 60546-2387

Phone

(708) 783-2970

Fax

(708) 783-2973

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1619985355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7234 OGDEN AVE",
            "address_2": "SUITE 1S",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605462387",
            "telephone_number": "708-783-2970",
            "fax_number": "708-783-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7234 OGDEN AVE",
            "address_2": "SUITE 1S",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605462387",
            "telephone_number": "708-783-2970",
            "fax_number": "708-783-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELYKYJ",
        "first_name": "SOPHIA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036069455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069455",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• VHS of Illinois Inc
• Village of Riverside
• Diane Louise Wallendjack, EDD, NCSP
• Minetta Wallingford, OTR/L
• Lee David Weiss, M.D.
• Westeros Family Practice, LTD
• Carly Williamson, SSP, NCSP
• Valerie Wodzinski, RN, MS
• Peter Yon
• Barbara Margaret Zabska-Szatkowski, MD

• Dermatology Physician in Riverside, IL
• Providers in Riverside, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.