Individual provider Active NPI

Lorene Y. Wu, M.D.

  • Family Medicine Physician
  • La Grange Park, IL
National Provider Identifier
1114075462
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0036-089752 Issued in IL
Practice address
48 E 31St St
La Grange Park, IL 60526-1024
Phone
(708) 352-7212
Fax
(708) 352-7228
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0036-089752 IL Primary

Addresses

Primary practice location

48 E 31St St
La Grange Park, IL 60526-1024

Mailing address

48 E 31St St
La Grange Park, IL 60526-1024
Phone (708) 352-7212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2014 through Apr 1, 2028

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Physical Therapy, Inc.Group PAC ID 4284607680, 41 clinicians

Practice addresses (Care Compare)

1049 Lake St
Suite 201
Oak Park, IL 60301-6708

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0036-089752ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Life Center Inc Family Medicine PastSince Feb 29, 2012 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114075462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 E 31ST ST",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261024",
            "telephone_number": "708-352-7212",
            "fax_number": "708-352-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 E 31ST ST",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261024",
            "telephone_number": "708-352-7212",
            "fax_number": "708-352-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "LORENE",
        "middle_name": "Y.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "0036-089752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange Park, IL

Sources for this page

Verify at the official NPI Registry.