John Wander, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036042495 Issued in IL

Practice address

908 N Elm St
Suite 310
Hinsdale, IL 60521-3625

Phone

(630) 325-3310

Fax

(630) 325-9163

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1366444150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 N ELM ST",
            "address_2": "SUITE 310",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213625",
            "telephone_number": "630-325-3310",
            "fax_number": "630-325-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N ELM ST",
            "address_2": "SUITE 310",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213625",
            "telephone_number": "630-325-3310",
            "fax_number": "630-325-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDER",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036042495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER #",
            "identifier": "020008007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP #",
            "identifier": "0002220321",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036024295",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CD5773",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherwin Waldman, M.D.
• Kelly Christine Waldvogel, AU.D.
• Walgreen Co
• Nicole Walsh
• Thomas Walsh, DO
• Dan Wang
• Brian Wardell, DMD
• Jesse G. Wardlow, M.D.
• Daniel Watts, CRNA
• Audrey L Wayne, MD

• Surgery Physician in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.