MRS. MARY COLLEEN WELLES (NPI# 1366768764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366768764 |
| Entity Type | Individual |
| Full Name | MRS. MARY COLLEEN WELLES |
| Credential | APN |
| Practice Address |
676 N Saint Clair St Suite 2125 Chicago IL 60611-2927 |
| Practice Telephone | 3129265400 |
| Practice Fax Number | 3129268885 |
| Mailing Telephone | 3129265400 |
| Mailing Fax Number | 3129268885 |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SX0200X |
Clinical Nurse Specialist Specialization: Oncology |
209.002324 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
676 N SAINT CLAIR ST SUITE 2125 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-2927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637272 | Alan Ara Boghosian | Dentist | 676 N Saint Clair St, Ste 1773, Chicago, IL 60611-2974 | 2005-05-24 |
| 1720542806 | Lindsey Lemmen | Social Worker | 676 N Saint Clair St, Chicago, IL 60611-2927 | 2019-01-23 |
| 1235633652 | Spencer Ng | Dermatology | 676 N Saint Clair St, Chicago, IL 60611 | 2018-03-20 |
| 1285168229 | Courtney Sperry | Physician Assistant | 676 N Saint Clair St, Suite 800, Chicago, IL 60611-2927 | 2017-04-17 |
| 1255872644 | Amanda Heepke | Nurse Practitioner | 676 N Saint Clair St, Suite 2125, Chicago, IL 60611-2927 | 2017-03-17 |
| 1295271088 | Roger Stupp | Internal Medicine | 676 N Saint Clair St, Suite 2210, Chicago, IL 60611-2927 | 2017-01-17 |
| 1356885099 | Jessica Mckinley | Nurse Practitioner | 676 N Saint Clair St, 9-900, Chicago, IL 60611-2927 | 2016-12-15 |
| 1376087239 | Sarah Hemphill | Social Worker | 676 N Saint Clair St, Chicago, IL 60611-2927 | 2016-12-12 |
| 1356885453 | Anne Kurze | Nurse Practitioner | 676 N Saint Clair St, 940, Chicago, IL 60611-2927 | 2016-12-07 |
| 1124562319 | Carolyn Chiu | Speech-Language Pathologist | 676 N Saint Clair St, Suite 1775, Chicago, IL 60611-2927 | 2016-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 364SX0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Oncology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497096853 | Mary Eileen Callaghan | Clinical Nurse Specialist | 250 E Superior St, Prentice 14-2226, Chicago, IL 60611-2914 | 2013-03-11 |
| 1902166754 | Kimberly Lisa Valachovic | Clinical Nurse Specialist | 676 N Saint Clair St, Suite 850, Chicago, IL 60611-2927 | 2012-05-25 |
| 1972746238 | Barbara Jean Gordon | Clinical Nurse Specialist | 5841 S Maryland Ave, Mc 5094 Room G-209, Chicago, IL 60637-1447 | 2009-04-15 |
| 1184839656 | Maryanne Fishman | Clinical Nurse Specialist | 676 N Saint Clair St, Stem Cell Transplant Suite 1920, Chicago, IL 60611-2927 | 2007-05-10 |
| 1851518070 | Linda Janisch | Clinical Nurse Specialist | 5841 S Maryland Ave, Mc2115, Chicago, IL 60637-1447 | 2007-04-19 |
| 1114140498 | Carol A White | Clinical Nurse Specialist | 5841 S Maryland Ave, Mc 2115, Chicago, IL 60637-1447 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073714663 | Carole Sims Henn Martz | Clinical Nurse Specialist | 757 Park West, Highland Park Hospital, Highland Park, IL 60035 | 2007-05-30 |
| 1972684066 | Valerie Wodzinski | Clinical Nurse Specialist | 119 Northgate, Riverside, IL 60541 | 2006-10-17 |
| 1124629035 | Carla Sue Smith | Clinical Nurse Specialist | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-11-06 |
| 1346870177 | Margaret M Gregus | Clinical Nurse Specialist | 121 N Elm St, Hinsdale, IL 60521-3765 | 2020-01-21 |
| 1245742949 | Jill C Benedeck | Clinical Nurse Specialist | 4305 W Medical Center Dr, Mchenry, IL 60050-8425 | 2017-11-02 |
| 1215224274 | Jacqueline Ann Rohaly-davis | Clinical Nurse Specialist | 15750 Marian Dr, Homer Glen, IL 60491-6200 | 2011-06-28 |
| 1043449416 | Deborah A. Stlaske | Clinical Nurse Specialist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2009-07-07 |
| 1225200702 | Mary M Brush | Clinical Nurse Specialist | 2160 S 1st Ave, Maywood, IL 60153 | 2008-03-25 |
| 1780889626 | Joann F Petty | Clinical Nurse Specialist | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2007-06-20 |
| 1245434851 | Rosemarie Batiste | Clinical Nurse Specialist | 120 Spalding Dr, Ste 111, Naperville, IL 60540-6766 | 2007-06-14 |
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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.