NPIMap

Organization Active NPI

Edward Health Ventures

  • Internal Medicine Physician
  • Bolingbrook, IL
National Provider Identifier
1780006569
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EDWARD HEALTH VENTURES
Practice address
404 W Boughton Rd
Ste a
Bolingbrook, IL 60440-1898
Phone
(630) 378-1774
Fax
(630) 378-1789
NPI assigned
Jan 13, 2014
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Bill Kottmann
Title
President
Phone
(630) 646-3950

Corporate family (same tax ID) 35

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

View all 35

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
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
Womens Center for Healt (36 organizations share this tax ID)

Locations

404 W Boughton Rd
Ste A
Bolingbrook, IL 60440
Phone (630) 378-1774

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

404 W Boughton Rd
Ste a
Bolingbrook, IL 60440-1898

Mailing address

27555 Diehl Rd
Entrance B
Warrenville, IL 60555-3849
Phone (630) 646-3950

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 13, 2014.

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1780006569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27555 DIEHL RD",
            "address_2": "ENTRANCE B",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553849",
            "telephone_number": "630-646-3950",
            "fax_number": "630-548-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W BOUGHTON RD",
            "address_2": "STE A",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401898",
            "telephone_number": "630-378-1774",
            "fax_number": "630-378-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD HEALTH VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "KOTTMANN",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-646-3950"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.