Western Springs Family Practice Center, LTD.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

42005694 Issued in IL

Legal business name

WESTERN SPRINGS FAMILY PRACTICE CENTER, LTD.

Practice address

5600 Wolf Rd
Western Springs, IL 60558-2254

Phone

(708) 246-7222

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Karen Rodgers

Title

Practice Manager

Phone

(708) 246-7222

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1417992306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 WOLF RD",
            "address_2": "SUITE 140",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605582254",
            "telephone_number": "708-246-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 WOLF RD",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605582254",
            "telephone_number": "708-246-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN SPRINGS FAMILY PRACTICE CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "708-246-7222"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "42005694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CF5017",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1617057",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trairud-Jack Watanachaiyot, D.P.T.
• Amy Waterwall, MPT, CEAS
• Ellen Welter, P.T.
• Western Springs Asthma & Allergy SC
• Western Springs Diagnostic Osteoporosis Center, LLC
• Lawrence Michael Wieczorek, LCSW
• Monica Williams, MA
• Lillie Winburn
• Courtney Wischhover
• Stephen Wisegarver

• Family Medicine Physician in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.