Organization Active NPI

Heartland Wellness Center PLLC

  • Family Nurse Practitioner
  • Homewood, IL
National Provider Identifier
1801571229
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HEARTLAND WELLNESS CENTER PLLC
Practice address
18036 Gottschalk Ave
Homewood, IL 60430-1712
Phone
(708) 491-2655
NPI assigned
Jun 21, 2023
Last updated
Jun 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Taletha K Brown, APNNPI 1689181372
Title
Apn
Phone
(708) 491-2655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

18036 Gottschalk Ave
Homewood, IL 60430-1712

Mailing address

304 Queens LN
Thornton, IL 60476-1080
Phone (708) 564-5071

Other practice location 1

304 Queens Ln
Thornton, IL 60476-1080
Phone (708) 564-5071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260108002072 IL Part B Supplier - Clinic/Group Practice 0244716355 Receives reassigned benefits from 1 practitioner
Practice locations: Homewood, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2325041Heartland Wellness Center PLLC18036 Gottschalk Ave, Homewood, IL 60430Certificate of waiverJun 4, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1801571229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 QUEENS LN",
            "city": "THORNTON",
            "state": "IL",
            "postal_code": "604761080",
            "telephone_number": "708-564-5071",
            "fax_number": "708-564-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18036 GOTTSCHALK AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301712",
            "telephone_number": "708-491-2655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 Queens Ln",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "IL",
            "postal_code": "604761080",
            "country_code": "US",
            "telephone_number": "708-564-5071",
            "fax_number": "708-564-5010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEARTLAND WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-21",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TALETHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "APN",
        "authorized_official_telephone_number": "708-491-2655",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.