NPIMap

Organization Active NPI

Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Crest Hill, IL
National Provider Identifier
1821229006
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EDWARD HEALTH VENTURES
Practice address
16151 Weber Road
Ste 201
Crest Hill, IL 60403-0865
Phone
(815) 838-2888
Fax
(815) 838-0222
NPI assigned
Aug 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Authorized official

Name
Mr. William Kottman
Title
President
Phone
(630) 646-3950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X IL Primary

Addresses

Primary practice location

16151 Weber Road
Ste 201
Crest Hill, IL 60403-0865

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
9919630OtherILBCBS

Other names 1

  • Edward Medical Group - Family Practice Crest Hill Other name

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
Womens Center for Healt36 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

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1821229006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27555 DIEHL ROAD",
            "address_2": "ENTRANCE B",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "60555",
            "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": "16151 WEBER ROAD",
            "address_2": "STE 201",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030865",
            "telephone_number": "815-838-2888",
            "fax_number": "815-838-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD HEALTH VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "KOTTMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-646-3950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9919630",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward Medical Group - Family Practice Crest Hill",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Crest Hill, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.