Individual provider Active NPI

Jessica Ruth Walter, M.D.

  • Reproductive Endocrinology Physician
  • Chicago, IL
National Provider Identifier
1467870261
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
036156432 Issued in IL
Practice address
259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone
(312) 695-7269
Fax
(312) 695-4924
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125065238 IL
Reproductive Endocrinology Physician 207VE0102X 036156432 IL Primary

Addresses

Primary practice location

259 E Erie St Ste 2400
Chicago, IL 60611-3907

Mailing address

259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone (312) 695-7269

Other practice location 1

240 E Huron St
Suite 1-200 (McGaw Medical Ctr Northwestern University)
Chicago, IL 60611-2909
Phone (312) 503-5230

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
I20210820001609 IL Practitioner - Obstetrics/Gynecology 8527367929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Harvard Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2021 Accepting new patients
Central Dupage Physician Group PastSince Sep 28, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 2400
Chicago, IL 60611
Phone (312) 694-9676

259 E Erie St
Chicago, IL 60611

250 E Superior St
Chicago, IL 60611
Phone (312) 472-2007

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1467870261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269",
            "fax_number": "312-695-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269",
            "fax_number": "312-695-4924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 E Huron St",
            "address_2": "Suite 1-200 (McGaw Medical Ctr Northwestern University)",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112909",
            "country_code": "US",
            "telephone_number": "312-503-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTER",
        "first_name": "JESSICA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125065238",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "IL",
            "license": "036156432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.