Individual provider Active NPI

Andrew Wang, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1023422797
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036144765 Issued in IL
Practice address
4753 N Broadway St Ste 403
Chicago, IL 60640-7910
Phone
(773) 989-2780
NPI assigned
Jun 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 81792 MN
Psychiatry Physician 2084P0800X 036144765 IL Primary

Addresses

Primary practice location

4753 N Broadway St Ste 403
Chicago, IL 60640-7910

Mailing address

4753 N Broadway St Ste 403
Chicago, IL 60640-7910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MN, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180717001612 IL Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 2466772710 Reassigns benefits to 1 organization
I20260430000232 MN Practitioner - Psychiatry 2466772710 Reassigns benefits to 1 organization
I20260528003852 TN Practitioner - Psychiatry 2466772710 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

4753 N Broadway St
Suite 403
Chicago, IL 60640-7910
Phone (773) 989-2780

7115 Forthun Rd
Suite 105
Baxter, MN 56425-8598
Phone (218) 454-0090

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036144765ILMDPsychiatry Physician
81792MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Aug 25, 2025 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Aug 25, 2025 Accepting new patients

Locations

4753 N Broadway St
Ste 403
Chicago, IL 60640
Phone (773) 989-2780

7115 Forthun Rd
Ste 105
Baxter, MN 56425
Phone (218) 454-0090

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

Interoperability endpoints

  • Direct secure messaging: andrew.wang.1@28621.direct.athenahealth.com

Organizations & group practices 6

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1023422797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4753 N BROADWAY ST STE 403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 N BROADWAY ST STE 403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407910",
            "telephone_number": "773-989-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-20",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "81792",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036144765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.