Organization Active NPI

Windy City Orthopaedics and Sports Medicine LTD

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1437351442
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036052836 Issued in IL
Legal business name
WINDY CITY ORTHOPAEDICS AND SPORTS MEDICINE LTD
Practice address
2617 W Peterson Ave
Chicago, IL 60659-4044
Phone
(847) 475-0200
Fax
(847) 475-7133
NPI assigned
Jun 1, 2007
Last updated
Aug 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Dr. Gary Klaud Miller
Title
President
Phone
(847) 475-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 036052836 IL Primary

Addresses

Primary practice location

2617 W Peterson Ave
Chicago, IL 60659-4044

Mailing address

2617 W Peterson Ave
Chicago, IL 60659-4044
Phone (847) 475-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050609000167 IL Part B Supplier - Clinic/Group Practice 6305889452 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Evanston, IL

National Provider Directory

National Provider Directory

Locations

800 Austin St
#260
Evanston, IL 60202
Phone (847) 475-0200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1437351442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594044",
            "telephone_number": "847-475-0200",
            "fax_number": "847-475-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594044",
            "telephone_number": "847-475-0200",
            "fax_number": "847-475-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDY CITY ORTHOPAEDICS AND SPORTS MEDICINE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "KLAUD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-475-0200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036052836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.