Individual provider Active NPI

Elsie R Walker, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1164510772
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036068920 Issued in IL
Practice address
8015 S Luella Ave
Suite 212
Chicago, IL 60617-1199
Phone
(773) 721-0470
Fax
(773) 721-0489
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036068920 IL Primary

Addresses

Primary practice location

8015 S Luella Ave
Suite 212
Chicago, IL 60617-1199

Mailing address

8015 S Luella Ave
Suite 212
Chicago, IL 60617-1199
Phone (773) 721-0470

Other identifiers 4

IdentifierTypeStateIssuer
3160223878OtherILBLUE CROSS BLUE SHIELD
036068920MedicaidIL
110022723OtherILRAIL ROAD MEDICARE
242068OtherILHARMONY

Other names 1

  • Elsie R Walker Thomas Other name

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
I20040518001433 IL Practitioner - Internal MedicinePractitioner - General Practice 7911998174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Southern Illinois University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8015 S Luella Ave
Suite 212
Chicago, IL 60617-1151
Phone (773) 721-0470

Hospital & facility affiliations

  • Crown Home Health Agency, Inc. Home health agency, Chicago, IL, CCN 147587
  • South Shore Hospital Hospital, Chicago, IL, CCN 140181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036068920ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elsie R. Walker M. D., P. C. Internal Medicine CurrentSince Apr 1, 1988 Accepting new patients

Locations

8015 S Luella Ave
Ste 21
Chicago, IL 60617
Phone (773) 721-0470

8015 S Luella Ave
Ste 212
Chicago, IL 60617
Phone (773) 721-0470

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJBBAA/Endpoint/EJBBAA
  • Direct secure messaging: ewalker@direct-address.org

Organizations & group practices 1

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 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1164510772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 S LUELLA AVE",
            "address_2": "SUITE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171199",
            "telephone_number": "773-721-0470",
            "fax_number": "773-721-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 S LUELLA AVE",
            "address_2": "SUITE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171199",
            "telephone_number": "773-721-0470",
            "fax_number": "773-721-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ELSIE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036068920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  BLUE SHIELD",
            "identifier": "3160223878",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068920",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110022723",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY",
            "identifier": "242068",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELSIE",
            "last_name": "WALKER THOMAS",
            "middle_name": "R",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.