Active NPI
John M. Wray, D.P.M.
- Podiatrist
- Chicago, IL
National Provider Identifier
1366436131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 016002772
- Practice address
- 30 N Michigan Ave
Suite 1129
Chicago, IL 60602-3402 - Phone
- (312) 372-0919
- Fax
- (312) 373-1606
- NPI assigned
- Sep 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 016002772 | IL | Primary |
Addresses
Primary practice location
30 N Michigan Ave
Suite 1129
Chicago, IL 60602-3402
Mailing address
30 N Michigan Ave
Suite 1129
Chicago, IL 60602-3402
Phone (312) 372-0919
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicfhir.aurora.org/FHIRMYADVOCATEAURORA/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | Advocate Aurora Healthcare |
| Direct Messaging Address | jwray251605@direct.myadvocateaurora.com | Health Information Exchange (HIE) |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080813000681 | IL | Practitioner - Podiatry | 1456426287 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016002772 | IL | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Podiatry Center, SC | Current | Accepting new patients |
Locations
30 N Michigan Ave
Ste 1129
Chicago, IL 60602
Phone (312) 372-0919
424 75th St
Downers Grove, IL 60516
Phone (630) 515-0705
Organizations & group practices 1
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": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638835200000",
"number": "1366436131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N MICHIGAN AVE",
"address_2": "SUITE 1129",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606023402",
"telephone_number": "312-372-0919",
"fax_number": "312-373-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N MICHIGAN AVE",
"address_2": "SUITE 1129",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606023402",
"telephone_number": "312-372-0919",
"fax_number": "312-373-1606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRAY",
"first_name": "JOHN",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-07",
"last_updated": "2021-12-07",
"certification_date": "2021-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "016002772",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicfhir.aurora.org/FHIRMYADVOCATEAURORA/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Advocate Aurora Healthcare",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "EMR",
"address_1": "1775 Dempster St",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681143",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jwray251605@direct.myadvocateaurora.com",
"affiliation": "N",
"endpointDescription": "EMR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "EMR",
"address_1": "30 N Michigan Ave",
"address_2": "Suite 1129",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606023402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.