Individual provider Active NPI

Jennifer Ann Weinberg, M.D.

  • Pediatrics Physician
  • Aurora, IL
National Provider Identifier
1184776619
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-121231 Issued in IL
Practice address
2000 Ogden Ave
Aurora, IL 60504-7222
Phone
(630) 978-6200
NPI assigned
Jan 17, 2007
Last updated
Aug 20, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 48954-020 WI
Pediatrics Physician 208000000X 036-121231 IL Primary

Addresses

Primary practice location

2000 Ogden Ave
Aurora, IL 60504-7222

Mailing address

3232 N Halsted St
#D407
Chicago, IL 60657-3476
Phone (773) 248-0558

Other identifiers 1

IdentifierTypeStateIssuer
34782100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-121231ILMDPediatrics Physician
48954-020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Empact Emergency Physicians LLC Past Accepting new patients
Pediatric Express Care LTD. Past 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, 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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1184776619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N HALSTED ST",
            "address_2": "#D407",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573476",
            "telephone_number": "773-248-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OGDEN AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047222",
            "telephone_number": "630-978-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBERG",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "48954-020",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-121231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34782100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.