Individual provider Active NPI

Sean David McWilliams, MD

  • Phlebology Physician
  • Wheaton, IL
National Provider Identifier
1356323398
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
License
036096961 Issued in IL
Practice address
180 Danada SQ W
Wheaton, IL 60189-2041
Phone
(630) 474-2600
Fax
(630) 474-2601
NPI assigned
Nov 16, 2005
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036096961 IL
Vascular Surgery Physician 2086S0129X 036096961 IL
Vascular Surgery Physician 2086S0129X 01062181A IN
Phlebology Physician 202K00000X 036096961 IL Primary

Addresses

Primary practice location

180 Danada SQ W
Wheaton, IL 60189-2041

Mailing address

180 Danada SQ W
Wheaton, IL 60189-2041
Phone (630) 474-2600

Other identifiers 3

IdentifierTypeStateIssuer
P00419402OtherINMEDICARE RAILROAD INDIVIDUAL PTAN
01622308OtherILBLUE CROSS
P00426506OtherILMEDICARE RAILROAD INDIVIDUAL PTAN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040601000559 IL Practitioner - General PracticePractitioner - Family PracticePractitioner - Peripheral Vascular DiseasePractitioner - Other (Physician) 8628059094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Peripheral Vascular Disease
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

180 Danada SQ W
Wheaton, IL 60189-2041
Phone (630) 474-2600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062181AINMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Danada Vein Care SC Phlebology CurrentSince May 1, 2024 Accepting new patients
Metrodocs, S.C. Family Medicine Past Accepting new patients
Connecticut Phlebology PC Phlebology PastSince Sep 21, 2012 Accepting new patients
Texas Interventional and Vascular Specialists PA Vascular Surgery PastSince Oct 9, 2022 Accepting new patients
Vein Clinics of Chicago LLC Vascular Surgery Past Accepting new patients

Locations

180 Danada Sq W
Wheaton, IL 60189
Phone (630) 474-2600

Organizations & group practices 5

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1356323398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 DANADA SQ W",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892041",
            "telephone_number": "630-474-2600",
            "fax_number": "630-474-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 DANADA SQ W",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892041",
            "telephone_number": "630-474-2600",
            "fax_number": "630-474-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "SEAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036096961",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036096961",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01062181A",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IL",
            "license": "036096961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD INDIVIDUAL PTAN",
            "identifier": "P00419402",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01622308",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD INDIVIDUAL PTAN",
            "identifier": "P00426506",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.