Vodicka Family Health & Wellness LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

VODICKA FAMILY HEALTH & WELLNESS LLC

Doing business as

Vodicka Family Health & Wellness LLC

Practice address

13045 Ravine Dr
Lemont, IL 60439-7331

Phone

(847) 703-0262

NPI assigned

Feb 22, 2022

Last updated

Feb 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Vodicka, NPNPI 1073924015

Title

Nurse Practitioner

Phone

(847) 703-0262

Specialties & licenses 1

Addresses

Other names 1

• VODICKA FAMILY HEALTH & WELLNESS LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

CLIA laboratory certificates

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.

• Jessica Vodicka

  • Family Nurse Practitioner
  • Lemont, IL
  • NPI 1073924015
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1912652645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13045 RAVINE DR",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604397331",
            "telephone_number": "847-703-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13045 RAVINE DR",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604397331",
            "telephone_number": "847-703-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VODICKA FAMILY HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "VODICKA",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "847-703-0262",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VODICKA FAMILY HEALTH & WELLNESS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Ustupska
• Iris Vaid
• Christina L Vazquez, MA
• Christian Vega, PTA
• Anna K Venhuizen
• Jessica Vodicka
• Emily Vrkljan, OTR
• Walgreen Co (Walgreens #03710)
• Meghan T Walsh, O.D.
• Waterfall Counseling LLC

• Health Service Clinic/Center in Lemont, IL
• Providers in Lemont, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.