Individual provider Active NPI

Rebecca Clare Wornhoff, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1114581584
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036171253 Issued in IL
Practice address
4720 S California Ave
Chicago, IL 60632-2016
Phone
(773) 584-6200
NPI assigned
Apr 30, 2019
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036171253 IL Primary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 289484 MA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4720 S California Ave
Chicago, IL 60632-2016

Mailing address

4720 S California Ave
Chicago, IL 60632-2016

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
I20240914000680 IL Practitioner - Family Practice 5991194276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esperanza Health CentersGroup PAC ID 2961453105, 53 clinicians

Practice addresses (Care Compare)

4720 S California Ave
Chicago, IL 60632-2016
Phone (773) 584-6200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036171253ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Centers Single Specialty Current Accepting new patients
Esperanza Health Centers CurrentSince Sep 23, 2024 Accepting new patients
Esperanza Health Centers Past Accepting new patients

Locations

1940 S Western Ave
#205
Chicago, IL 60608
Phone (631) 877-0913

2001 S California Ave
Chicago, IL 60608
Phone (773) 484-1201

2001 S California Ave
Ste 100
Chicago, IL 60608
Phone (773) 640-5785

4720 S California Ave
Chicago, IL 60632
Phone (312) 942-2877

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rebecca.wornhoff.1@11903.direct.athenahealth.com
  • Direct secure messaging: rebecca.wornhoff.1@3547.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1114581584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606322016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606322016",
            "telephone_number": "773-584-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORNHOFF",
        "first_name": "REBECCA",
        "middle_name": "CLARE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036171253",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "289484",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.