Thomas Lee Waidzunas, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-078350 Issued in IL

Practice address

7600 W College Dr
Palos Heights, IL 60463-1001

Phone

(708) 361-8449

Fax

(708) 361-8469

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Premiere General Medicine S C

  • Internal Medicine Physician
  • Palos Heights, IL
  • NPI 1437584364
  Medicare reassignment NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1114931862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631001",
            "telephone_number": "708-361-8449",
            "fax_number": "708-361-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631001",
            "telephone_number": "708-361-8449",
            "fax_number": "708-361-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIDZUNAS",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-078350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pierre T.H. Vo, M.D.
• Victoria Marie Vorderer, DDS
• Kurt J Wagner, M.D.
• Lauren Wagner, LSW
• Marium Wahid
• Brian Waishwell, M.A.
• Walgreen Co (Walgreens #09347)
• Walgreen Co. (Walgreens #9347)
• Walid Habbal DDS PC
• Tenille Tenille Wallace-Bell, LPC

• Family Medicine Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.