Active NPI
Thomas A Wiedrich, MD
- Orthopaedic Hand Surgery Physician
- Chicago, IL
National Provider Identifier
1124080189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 36074824
- Practice address
- 737 N Michigan Ave
Ste 700
Chicago, IL 60611-6662 - Phone
- (312) 337-6960
- Fax
- (312) 337-3601
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 36074824 | IL | Primary |
Addresses
Primary practice location
737 N Michigan Ave
Ste 700
Chicago, IL 60611-6662
Mailing address
737 N Michigan Ave
Ste 700
Chicago, IL 60611-6662
Phone (312) 337-6960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036074824 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36074824 | IL | MD | Orthopaedic Hand Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259625600000",
"number": "1124080189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "737 N MICHIGAN AVE",
"address_2": "STE 700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606116662",
"telephone_number": "312-337-6960",
"fax_number": "312-337-3601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "737 N MICHIGAN AVE",
"address_2": "STE 700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606116662",
"telephone_number": "312-337-6960",
"fax_number": "312-337-3601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDRICH",
"first_name": "THOMAS",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2009-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "IL",
"license": "36074824",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036074824",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.