NPIMap

Organization Active NPI

Oswego Wellness, Inc

  • Community/Behavioral Health Agency
  • Oswego, IL
National Provider Identifier
1912373069
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
OSWEGO WELLNESS, INC
Practice address
64 Main St
Oswego, IL 60543-9893
Phone
(630) 519-1010
Fax
(630) 405-7209
NPI assigned
Aug 12, 2015
Last updated
Dec 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Mrs. Heather Ann Johnson, LCSW
Title
Clinical Director
Phone
(630) 519-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

64 Main St
Oswego, IL 60543-9893

Mailing address

64 Main St
Oswego, IL 60543-9893
Phone (630) 519-1010

Other practice location 1

15003 S Route 59
Plainfield, IL 60544-2730
Phone (630) 519-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171115000213 IL Part B Supplier - Clinic/Group Practice 3274899844 Receives reassigned benefits from 7 practitioners
Practice locations: Oswego, IL

National Provider Directory

National Provider Directory

Locations

67 Main St
Ste 2A
Oswego, IL 60543
Phone (630) 519-1010

15003 S Route 59
Plainfield, IL 60544
Phone (630) 519-1010

Practitioners & affiliated clinicians

Practitioners 12

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": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1912373069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MAIN ST",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605439893",
            "telephone_number": "630-519-1010",
            "fax_number": "630-405-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MAIN ST",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605439893",
            "telephone_number": "630-519-1010",
            "fax_number": "630-405-7209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15003 S Route 59",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IL",
            "postal_code": "605442730",
            "country_code": "US",
            "telephone_number": "630-519-1010",
            "fax_number": "630-405-7209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OSWEGO WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "630-519-1010",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.