Teresa A. Wanczyk, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036-065883 Issued in IL

Practice address

3414 W Peterson Ave
Ste. D
Chicago, IL 60659-3452

Phone

(773) 271-2900

Fax

(773) 267-6113

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Teresa A Grosvenor Other name

Electronic endpoints 1

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

Specialty

Osteopathic Manipulative MedicineAlso: General Practice, Pain Management, Pediatric Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 1980

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: twanczyk@tw-il.direct.office.nextgen.com
• Direct secure messaging: twanczyk@direct.meditouchehr.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• The Sun Will Come Out PLLC

  • Chiropractor
  • Niles, IL
  • NPI 1528909728
  NPD
• Teresa a. Wanczyk

  • Neuromusculoskeletal Medicine & OMM Physician
  • Chicago, IL
  • NPI 1275837734
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1285732198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6234 N ALBANY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591402",
            "telephone_number": "773-271-2900",
            "fax_number": "773-267-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 W PETERSON AVE",
            "address_2": "STE. D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593452",
            "telephone_number": "773-271-2900",
            "fax_number": "773-267-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANCZYK",
        "first_name": "TERESA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IL",
            "license": "036-065883",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-065883",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036-065883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065883",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twanczyk@TW-IL.direct.office.nextgen.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3414 W Peterson Ave",
            "address_2": "Ste. D",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606593452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "GROSVENOR",
            "middle_name": "A",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Regina Wan, MSN, NNP-BC
• Vivian Wan
• William Kwok Kuen Wan, M.D.
• Christine Wancket, SLP
• Sarah E Wancowicz, DPT
• Joyce Alene Wandel
• Sheryl Ann Wandler, LCSW
• Nicole Rochelle Wandschneider, FNP
• Wang Behavioral Healthcare S.C.
• Amy Y. Wang, M.D.

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.