MEDICARE: WELLCARE HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1225757032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLCARE HEALTH PLLC

Provider Business Mailing Address
First Line	:	2553 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4019
Country	:	US
Telephone Number	:	773-784-1025
Fax Number	:	773-784-1056

Provider Business Practice Location Address
First Line	:	2553 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4019
Country	:	US
Telephone Number	:	773-784-1025
Fax Number	:	773-784-1056

Authorized Official
Title or Position	:	MANAGER
Name	:	KAREEM M SYED SHAH
Credential	:
Telephone Number	:	630-748-9407

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	05/13/2026

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