Lauren Woldanski, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

125077240 Issued in IL

Practice address

747 N Rutledge St
Springfield, IL 62702-6700

Phone

(217) 545-6112

Fax

(217) 545-2588

NPI assigned

Jul 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1376151258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19653",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949653",
            "telephone_number": "217-545-6112",
            "fax_number": "217-545-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-6112",
            "fax_number": "217-545-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDANSKI",
        "first_name": "LAUREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "125077240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Aloisius Witcik, R.PH
• Dale Lynn Wohlrabe, D.C.
• Melissa Wohrley, PA-C
• Mark Wojdyla, MD
• Stephanie E. Wojtowicz, M.D.
• Derrick J Wolf, FNP
• Eric D Wolf, PA
• Kari Marguerite Wolf, M.D.
• Myranda Nycole Wolff, DMD
• Barbara J. Wolfson, L.C.P.C.

• Plastic Surgery Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.