NPIMap

Organization Active NPI

Edward Health Ventures

  • Family Medicine Physician
  • Woodridge, IL
National Provider Identifier
1841608924
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EDWARD HEALTH VENTURES
Practice address
2317 75TH St
Woodridge, IL 60517-2302
Phone
(630) 527-3645
NPI assigned
Aug 1, 2014
Last updated
Aug 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X IL
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

2317 75TH St
Woodridge, IL 60517-2302

Mailing address

27555 Diehl Rd
Entrance B
Warrenville, IL 60555-3849

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
Edw Hosp Womens CNTR F36 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 2

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": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1841608924",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 75TH ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172302",
            "telephone_number": "630-527-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD HEALTH VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

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