Individual provider Active NPI

Natalie Joann Kalvoda, FNP

  • Family Nurse Practitioner
  • Bolingbrook, IL
National Provider Identifier
1639521669
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.014379 Issued in IL
Practice address
420 Remington Blvd Ste 125
Bolingbrook, IL 60440-4950
Phone
(630) 312-4505
NPI assigned
Jul 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.014379 IL Primary

Addresses

Primary practice location

420 Remington Blvd Ste 125
Bolingbrook, IL 60440-4950

Mailing address

420 S. Schmidt Road
#240
Bolingbrook, IL 60440-1452
Phone (630) 312-4505

Other names 1

  • Miss Natalie Joann Wolfer Other name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180131002613 IL Practitioner - Nurse Practitioner 4486914967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chicagoland Pain Management Institute IncGroup PAC ID 1850536830, 8 clinicians

Practice addresses (Care Compare)

420 S Schmidt Rd
Suite 110
Bolingbrook, IL 60440-1756
Phone (630) 312-4562

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.014379ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chicagoland Pain Management Institute, Inc. CurrentSince Dec 17, 2017 Accepting new patients

Locations

420 N Schmidt Rd
Ste 125
Bolingbrook, IL 60440
Phone (630) 312-4500

26358 Network Pl
Chicago, IL 60673

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: natalie.kalvoda.1@13549.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/13549/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1639521669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S. SCHMIDT ROAD",
            "address_2": "#240",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401452",
            "telephone_number": "630-312-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 REMINGTON BLVD STE 125",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404950",
            "telephone_number": "630-312-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALVODA",
        "first_name": "NATALIE",
        "middle_name": "JOANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-01",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "WOLFER",
            "middle_name": "JOANN",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.