WELLCARE PHYSICIAN SERVICES, INC. (NPI# 1669623575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669623575 |
| Entity Type | Organization |
| Organization Name | WELLCARE PHYSICIAN SERVICES, INC. |
| Practice Address |
8905 S Francisco Ave Evergreen Park IL 60805-1251 |
| Practice Telephone | 7083597526 |
| Mailing Telephone | 7083597526 |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |
| Authorized Official Name | ENO NSIMA-OBOT (OWNER) |
| Authorized Official Telephone | 7083597526 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 336059478 | IL | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 036099035 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
8905 S FRANCISCO AVE |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-1251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033443403 | Experience Health, S.c. | Internal Medicine | 2850 W 95th St Ste 301, Evergreen Park, IL 60805-2741 | 2009-10-01 |
| 1811013857 | Brian Hugh | Internal Medicine | 2850 W 95th St Ste 11, Evergreen Park, IL 60805-2727 | 2007-03-21 |
| 1942394499 | Satwant Kingra | Internal Medicine | 2733 W 87th St, Evergreen Park, IL 60805-1104 | 2006-10-02 |
| 1558477661 | Hamdi Mansour Khilfeh | Internal Medicine | 2955 W. 95th St, Evergreen Park, IL 60805-2004 | 2006-08-22 |
| 1164435293 | Stanley Anthony Polit | Internal Medicine | 2850 West 95th Street, Suite 11, Evergreen Park, IL 60805 | 2006-08-13 |
| 1205869815 | Ejikeme O Obasi | Internal Medicine | 9125 S Pulaski Rd, Evergreen Park, IL 60805-1441 | 2006-07-08 |
| 1174582811 | Abdallah Altarshan | Internal Medicine | 2955 W 95th St, Evergreen Park, IL 60805-2409 | 2006-03-21 |
| 1184683849 | Mohammad Abdur Razzaque | Internal Medicine | 3228 W 95th St, Evergreen Park, IL 60805-2314 | 2006-03-21 |
| 1306836663 | Thomas Joseph | Internal Medicine | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2005-10-26 |
| 1649274119 | Gopal Madhav | Internal Medicine | 3900 W 95th St, Ste 6, Evergreen Park, IL 60805-1901 | 2005-06-12 |
| Find all providers in EVERGREEN PARK | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.