Individual provider Active NPI

Wendy Tan

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1265889679
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1611 W Harrison St
Chicago, IL 60612-4861
Phone
(312) 243-4244
NPI assigned
May 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1611 W Harrison St
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St
Chicago, IL 60612-4861
Phone (312) 243-4244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161018000621 IN Practitioner - Physician Assistant 2567750904 Reassigns benefits to 2 organizations
I20161019000672 IL Practitioner - Physician Assistant 2567750904 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Physician Assistant CurrentSince Jul 1, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Sep 16, 2016 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Sep 16, 2016 Accepting new patients
Mor Physician Network LLC PastSince Jul 30, 2019 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Chicago, IL 60612
Phone (312) 243-4244

963 N 129th Infantry Dr
Ste 130
Joliet, IL 60435
Phone (815) 744-1812

55 Shuman Blvd
Ste 700
Naperville, IL 60563
Phone (630) 339-2225

2011 York Rd
Ste 1500
Oak Brook, IL 60523
Phone (708) 492-5630

2450 Wolf Rd
Ste F
Westchester, IL 60154
Phone (708) 236-2750

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

9200 Calumet Ave
Ste 300
Munster, IN 46321
Phone (708) 236-2737

9200 Calumet Ave
Ste S300
Munster, IN 46321
Phone (708) 492-5460

9200 Calumet Ave
#300
Munster, IN 46321

Interoperability endpoints

  • Direct secure messaging: wendy.tan.1@12576.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1265889679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-243-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-243-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "WENDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.