NPIMap

Individual provider Active NPI

Pierre E Wakim, D.O.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1235143405
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036082409 Issued in IL
Practice address
500 E 51St St
Chicago, IL 60615-2400
Phone
(630) 248-3563
NPI assigned
Jul 27, 2006
Last updated
Mar 9, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036082409 IL Primary

Addresses

Primary practice location

500 E 51St St
Chicago, IL 60615-2400

Mailing address

107 Oak Ridge Dr W
Burr Ridge, IL 60527-6868
Phone (630) 248-3563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080710000067 IL Practitioner - Emergency Medicine 4981685021 Reassigns benefits to 3 organizations
I20221102002514 CO Practitioner - Emergency Medicine 4981685021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Anthony Emergency Services Physician GroupGroup PAC ID 5698744076, 15 clinicians
Great Lakes Emergency Physicians Medical Group SCGroup PAC ID 8527493105, 15 clinicians

Practice addresses (Care Compare)

2875 W 19TH St
Chicago, IL 60623-3501
Phone (773) 484-1000

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine Current Accepting new patients
Cook County Current Accepting new patients
Great Lakes Emergency Physicians Medical Group SC Emergency Medicine CurrentSince Feb 1, 2021 Accepting new patients
St Anthony Emergency Services Physician Group CurrentSince Mar 2, 2024 Accepting new patients
Cook County Emergency Medicine CurrentSince Nov 23, 2010 Accepting new patients
Cook County CurrentSince Nov 23, 2010 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Westlake Emergency Room Providers, SC Emergency Medicine PastSince Jan 11, 2013 Accepting new patients
Emergency Room Care Providers, S.C. Emergency Medicine PastSince Nov 4, 2002 Accepting new patients
Emergency Room Providers, S.C. PastSince Jan 16, 2011 Accepting new patients

Locations

7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

Organizations & group practices 11

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.

Hospital & facility affiliations 9

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1235143405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 OAK RIDGE DR W",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276868",
            "telephone_number": "630-248-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 51ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152400",
            "telephone_number": "630-248-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKIM",
        "first_name": "PIERRE",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036082409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.