Individual provider Active NPI

Marie A Veldman, DO

  • Family Medicine Physician
  • Homer Glen, IL
National Provider Identifier
1740280312
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-078204 Issued in IL
Practice address
12701 W 143Rd St
Ste 230
Homer Glen, IL 60491-7715
Phone
(708) 301-6702
Fax
(708) 301-3421
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-078204 IL Primary

Addresses

Primary practice location

12701 W 143Rd St
Ste 230
Homer Glen, IL 60491-7715

Mailing address

12701 W 143Rd St
Ste 230
Homer Glen, IL 60491-7715
Phone (708) 301-6702

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051206000834 IL Practitioner - Family Practice 7315967239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-078204ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, Inc Family Medicine CurrentSince Dec 31, 2015 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 1, 2006 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jan 1, 2006 Accepting new patients
Health Service Systems, Inc CurrentSince Dec 31, 2015 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Primary Health Associates PC Family Medicine Past Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

29373 Network Pl
Chicago, IL 60673

12701 W 143rd St
Ste 230
Homer Glen, IL 60491
Phone (708) 226-1206

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

10811 W 143rd St
Ste 100
Orland Park, IL 60467
Phone (708) 460-2500

16750 80th Ave
Ste A
Tinley Park, IL 60477
Phone (708) 444-1880

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGEBDA

Organizations & group practices 6

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 2

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1740280312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 W 143RD ST",
            "address_2": "STE 230",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604917715",
            "telephone_number": "708-301-6702",
            "fax_number": "708-301-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 W 143RD ST",
            "address_2": "STE 230",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604917715",
            "telephone_number": "708-301-6702",
            "fax_number": "708-301-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELDMAN",
        "first_name": "MARIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-078204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

Verify at the official NPI Registry.