EDWARD HEALTH VENTURES NPI 1356632657

NPI Information

  • NPI: 1356632657
  • Provider Name: EDWARD HEALTH VENTURES
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Doing Business As: EDWARD MEDICAL GROUP
  • CLIA Number: 14D1048932
  • Address: 130 WEBER ROAD
    STE 100
    BOLINGBROOK, IL
    ZIP 60440
  • Phone: (630) 646-5777

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NPI Details

EDWARD HEALTH VENTURES is a multi-specialty clinic center in Bolingbrook, IL. EDWARD HEALTH VENTURES NPI is 1356632657. The provider is registered as an organization entity type.
The provider Is Doing Business As Edward Medical Group.

The provider's business location address is:

130 WEBER ROAD
STE 100
BOLINGBROOK, IL
ZIP 60440-519
Phone: (630) 646-5777
Fax: (630) 646-5729

The provider's authorized official is Bill Kottman .
The authorized official title is President and has the following contact phone number (630) 646-3388.

The CLIA number assigned to this NPI record is 14D1048932 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/21/2011 and was last updated on 12/14/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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