Individual provider Active NPI

Linda C Wagner-Weiner, MD

  • Pediatric Rheumatology Physician
  • Burr Ridge, IL
National Provider Identifier
1366592313
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
Practice address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone
(773) 834-4064
NPI assigned
Jan 11, 2007
Last updated
Jul 13, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X IL Primary

Addresses

Primary practice location

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686

Mailing address

5841 S Maryland Ave # Mc1099
Chicago, IL 60637-1447

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
I20040527000510 IL Practitioner - Pediatric MedicinePractitioner - Emergency MedicinePractitioner - Rheumatology 3779564588 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Jun 1, 2020 Accepting new patients
Shriners Hospitals for Children CurrentSince Jun 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 3, 2013 Accepting new patients
University of Chicago CurrentSince Nov 7, 2018 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

180 Harvester Dr
Ste 110
Burr Ridge, IL 60527
Phone (773) 702-1061

2211 N Oak Park Ave
Chicago, IL 60707
Phone (773) 385-5463

29373 Network Pl
Chicago, IL 60673

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: lwagnerweinermd23194@uchospital.direct-ci.com

Organizations & group practices 7

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1366592313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC1099",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-834-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER-WEINER",
        "first_name": "LINDA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.