Individual provider Active NPI

Daniel Robert Wahlstrom, MD

  • Neurology Physician
  • Hinsdale, IL
National Provider Identifier
1265013619
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036-171744 Issued in IL
Practice address
908 N Elm St Ste 110
Hinsdale, IL 60521-2600
Phone
(630) 986-8770
Fax
(630) 986-8776
NPI assigned
Apr 17, 2021
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 125-078946 IL
Neurology Physician 2084N0400X 4301514850 MI
Neurology Physician 2084N0400X 036-171744 IL Primary

Addresses

Primary practice location

908 N Elm St Ste 110
Hinsdale, IL 60521-2600

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone (312) 942-7100

Other practice location 2

850 W Baraga Ave Ste 31
Marquette, MI 49855-4550
Phone (906) 449-3600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwahlstrom305631@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250701002166 IL Practitioner - Neurology 5395140792 Reassigns benefits to 1 organization
I20250724000784 MI Practitioner - Neurology 5395140792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wayne State University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

850 W Baraga Ave
Marquette, MI 49855-4550
Phone (906) 449-3610

908 N Elm St
Suite 110
Hinsdale, IL 60521-2600
Phone (630) 986-8770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-171744ILMDNeurology Physician
4301514850MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Aug 1, 2025 Accepting new patients
DLP Marquette Physician Practices Inc Neurology CurrentSince Aug 1, 2025 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 4, 2025 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 4, 2025 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

908 N Elm St
Ste 110
Hinsdale, IL 60521
Phone (630) 986-8770

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

850 W Baraga Ave
Ste 31
Marquette, MI 49855
Phone (906) 449-3600

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: daniel.wahlstrom.1@8233.direct.athenahealth.com
  • Direct secure messaging: dwahlstrom305631@dulyhealthandcare.direct-ci.com

Organizations & group practices 4

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 3

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": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1265013619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N ELM ST STE 110",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212600",
            "telephone_number": "630-986-8770",
            "fax_number": "630-986-8776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Paulina St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123806",
            "country_code": "US",
            "telephone_number": "312-942-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 W Baraga Ave Ste 31",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498554550",
            "country_code": "US",
            "telephone_number": "906-449-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHLSTROM",
        "first_name": "DANIEL",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-17",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "125-078946",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301514850",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-171744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwahlstrom305631@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "908 N Elm St Ste 110",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605212600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.