Individual provider Active NPI

Courtney Weems, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1427369362
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036132165 Issued in IL
Practice address
3916 N Damen Ave
Chicago, IL 60618
Phone
(773) 644-1362
Fax
(773) 828-4849
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 036132165 IL Primary

Addresses

Primary practice location

3916 N Damen Ave
Chicago, IL 60618

Mailing address

3916 N Damen Ave
Chicago, IL 60618-3906
Phone (773) 644-1362

Other practice location 1

909 Davis St Ste 200
Evanston, IL 60201-3664
Phone (847) 866-3700

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
I20141124001147 IL Practitioner - Pediatric Medicine 2769704022 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036132165ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Single Specialty CurrentSince Nov 1, 2014 Accepting new patients
Endeavor Health Medical Group Single Specialty CurrentSince Nov 1, 2014 Accepting new patients
Donohoe Pediatrics LTD. Single Specialty Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

909 Davis St
Ste 200
Evanston, IL 60201
Phone (847) 866-3700

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

Interoperability endpoints

  • Direct secure messaging: courtney.weems@199582864048132.direct.elationemr.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1427369362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183906",
            "telephone_number": "773-644-1362",
            "fax_number": "773-828-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-644-1362",
            "fax_number": "773-828-4849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Davis St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602013664",
            "country_code": "US",
            "telephone_number": "847-866-3700",
            "fax_number": "847-866-3731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEEMS",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036132165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.