Stephanie M Weller, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036129096 Issued in IL

Practice address

1945 W Wilson Ave Ste 4000
Chicago, IL 60640-5255

Phone

(773) 736-6220

Fax

(773) 736-3941

NPI assigned

Sep 28, 2006

Last updated

Dec 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• PCC Community Wellness Center

  dba PCC Austin Dental & Specialty Care Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• Family Service and Mental Health Center of Cicero

  • Community/Behavioral Health Agency
  • Oak Park, IL
  • NPI 1265705990
  NPD (past)
• Oak Park River Forest Infant Welfare Society

  dba Infant Welfare Clinic

  • Dentist
  • Oak Park, IL
  • NPI 1134258916

  Pediatrics

  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1891886164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE STE 4000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405255",
            "telephone_number": "773-736-6220",
            "fax_number": "773-736-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE STE 4000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405255",
            "telephone_number": "773-736-6220",
            "fax_number": "773-736-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036129096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036129096",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1945 W Wilson Ave Ste 4000",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606405255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sweller224621@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1945 W Wilson Ave Ste 4000",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606405255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wellbeing Chiropractic SC
• Wellcare Enterprises LLC
• Wellcare Health PLLC (WellCare Health)
• Jeffrey A. Weller, D.D.S.
• Katherine Grace Claudia Weller
• Jasmeen Wellere
• Mary Colleen Welles, APN
• Celeste Wellin, LCSW
• Wellington Psychological Services, PC
• Wellington Radiology Group, S.C.

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.