Timothy S Wollner, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036073267 Issued in IL

Practice address

2850 W 95TH St
Suite 101
Evergreen Park, IL 60805-2735

Phone

(708) 425-9550

Fax

(708) 229-6084

NPI assigned

Jul 3, 2006

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 2

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 Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twollner123447@direct.rush.rush-health.com

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.

• Little Company of Mary Affiliated Services Inc

  • Urgent Care Clinic/Center
  • Oak Lawn, IL
  • NPI 1033162086
  Medicare reassignment NPD
• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Family Medicine

  Medicare reassignment NPD
• Little Company of Mary Affiliated Services Inc

  • Internal Medicine Physician
  • Evergreen Park, IL
  • NPI 1588617260
  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1427088061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9550",
            "fax_number": "708-229-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9550",
            "fax_number": "708-229-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLNER",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036073267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073267",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080055203",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Danielle Williams, APRN, FNP-C
• Ishmaella R Wilson-Mills, APN
• Frederick Edward Wohlberg, M.D.
• Denise H Wojciechowski, DC
• Lilla Wojciechowski
• Women'S Healthcare of Illinois, LTD
• Wood SLP Services LLC
• David C Wright, CRNA
• Alex Chun Wu, M.D.
• Rita Wyrebek, MD MS

• Family Medicine Physician in Evergreen Park, IL
• Providers in Evergreen Park, 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 Jan 21, 2016; 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.