Illinois Wellness and Weight Loss Centers SC

Primary specialty

Obesity Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VB0002X

Legal business name

ILLINOIS WELLNESS AND WEIGHT LOSS CENTERS SC

Practice address

9933 South Western Avenue
Suite 200
Chicago, IL 60643-1810

Phone

(708) 325-8615

NPI assigned

Jul 19, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Goldwyn B Foggie, M.D.

Title

Ceo

Phone

(708) 325-8616

Specialties & licenses 2

Addresses

Other names 1

• None Doing business as

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1992158562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 SOUTH WESTERN AVENUE",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431810",
            "telephone_number": "708-325-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 SOUTH WESTERN AVENUE",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431810",
            "telephone_number": "708-325-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS WELLNESS AND WEIGHT LOSS CENTERS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "FOGGIE",
        "authorized_official_first_name": "GOLDWYN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-325-8616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.