NPIMap

Organization Active NPI

Edward Health Ventures

Doing business as Edward Medical Group - Monarch Landing

  • Internal Medicine Physician
  • Naperville, IL
National Provider Identifier
1760749535
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EDWARD HEALTH VENTURES
Doing business as
Edward Medical Group - Monarch Landing
Practice address
2255 Monarch Dr
Naperville, IL 60563-4164
Phone
(630) 300-1125
Fax
(630) 300-1394
NPI assigned
Apr 18, 2012
Last updated
Dec 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Authorized official

Name
Bill Kottman
Title
President
Phone
(630) 646-3388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

2255 Monarch Dr
Naperville, IL 60563-4164

Mailing address

120 Osler
Lower Level
Naperville, IL 60540-7429
Phone (630) 646-3388

Other names 1

  • Edward Medical Group - Monarch Landing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000616 IL Part B Supplier - Clinic/Group Practice 4284531484 Receives reassigned benefits from 656 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Edward Health Ventures36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

303 W Lake St
Ste 301
Addison, IL 60101
Phone (331) 221-1650

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1760749535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OSLER",
            "address_2": "LOWER LEVEL",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407429",
            "telephone_number": "630-646-3388",
            "fax_number": "630-548-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 MONARCH DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634164",
            "telephone_number": "630-300-1125",
            "fax_number": "630-300-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD HEALTH VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "KOTTMAN",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-646-3388"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward Medical Group - Monarch Landing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.