Individual provider Active NPI

David Winters, MD

  • Family Medicine Physician
  • Lockport, IL
National Provider Identifier
1013965987
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036070277 Issued in IL
Practice address
1206 E 9TH St
Lockport, IL 60441
Phone
(630) 967-3470
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036070277 IL Primary

Addresses

Primary practice location

1206 E 9TH St
Lockport, IL 60441

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-1369
Phone (630) 469-2000

Other practice location 1

2363 63rd St
Woodridge, IL 60517-1369
Phone (630) 716-7510

Other practice location 2

2363 63rd St
Woodridge, IL 60517-1369
Phone (630) 716-7510

Other identifiers 1

IdentifierTypeStateIssuer
036070277MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100721000260 IL Practitioner - Family Practice 2365574761 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036070277ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Dec 2, 2019 Accepting new patients
Dupage Medical Group LTD CurrentSince Dec 2, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1206 E 9th St
Lockport, IL 60441
Phone (708) 406-3328

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1013965987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606741369",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E 9TH ST",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "60441",
            "telephone_number": "630-967-3470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2363 63rd St",
            "address_purpose": "LOCATION",
            "city": "Woodridge",
            "state": "IL",
            "postal_code": "605171369",
            "country_code": "US",
            "telephone_number": "630-716-7510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2363 63rd St",
            "address_purpose": "LOCATION",
            "city": "Woodridge",
            "state": "IL",
            "postal_code": "605171369",
            "country_code": "US",
            "telephone_number": "630-716-7510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036070277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070277",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

Verify at the official NPI Registry.