Individual provider Active NPI

Walter J McCarthy III, MD

  • Vascular Surgery Physician
  • Chicago, IL
National Provider Identifier
1477667681
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036060512 Issued in IL
Practice address
1725 W Harrison St
Suite 1156
Chicago, IL 60612-3841
Phone
(312) 563-2763
Fax
(312) 563-4388
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036060512 IL Primary

Addresses

Primary practice location

1725 W Harrison St
Suite 1156
Chicago, IL 60612-3841

Mailing address

1725W Harrison St 1156
Chicago, IL 60612-3852
Phone (312) 563-2762

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
I20100723000967 IL Practitioner - Vascular Surgery 9032241146 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036060512ILMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Nov 30, 2011 Accepting new patients
Cook County CurrentSince Nov 30, 2011 Accepting new patients
Cook County Current Accepting new patients
Rush University Medical Group CurrentSince Jan 14, 2019 Accepting new patients
Rush University Medical Center CurrentSince Jan 14, 2019 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1725 W Harrison St
Ste 1156
Chicago, IL 60612
Phone (312) 563-2762

1725 W Harrison St
Ste 115
Chicago, IL 60612
Phone (312) 829-2540

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Interoperability endpoints

  • Direct secure messaging: wmccarthy3948@direct.rush.rush-health.com

Organizations & group practices 5

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1477667681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725W HARRISON ST 1156",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123852",
            "telephone_number": "312-563-2762",
            "fax_number": "312-563-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 1156",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-563-2763",
            "fax_number": "312-563-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "WALTER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036060512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.