Elemental Wellness Center LTD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

Legal business name

ELEMENTAL WELLNESS CENTER LTD

Practice address

14484 John Humphrey Dr
Orland Park, IL 60462-2638

Phone

(708) 364-0580

Fax

(708) 364-0480

NPI assigned

Jun 16, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Martins Adeoye, MD

Title

MD Ceo

Phone

(708) 553-0303

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1700516168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14484 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622638",
            "telephone_number": "708-364-0580",
            "fax_number": "708-364-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14484 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622638",
            "telephone_number": "708-364-0580",
            "fax_number": "708-364-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTAL WELLNESS CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "ADEOYE",
        "authorized_official_first_name": "MARTINS",
        "authorized_official_title_or_position": "MD CEO",
        "authorized_official_telephone_number": "708-553-0303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Preventive Medicine) Physician in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Addiction Medicine (Preventive Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.