Individual provider Active NPI

Wolf D Peddinghaus, M.D.

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1487640660
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036053477 Issued in IL
Practice address
9701 Knox Ave
Suite 102
Skokie, IL 60076-1256
Phone
(847) 677-1112
Fax
(847) 674-3358
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036053477 IL Primary

Addresses

Primary practice location

9701 Knox Ave
Suite 102
Skokie, IL 60076-1256

Mailing address

9701 Knox Ave
Suite 102
Skokie, IL 60076-1256
Phone (847) 677-1112

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
I20050902000394 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9537191192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

4901 Searle Pkwy
Suite 150
Skokie, IL 60077-1057

9977 Woods Dr
Skokie, IL 60077-1057
Phone (847) 663-8062

9977 Woods Dr 2ND Floor
Skokie, IL 60077-1057
Phone (847) 663-8370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36053477ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Jan 1, 2009 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 1, 2009 Accepting new patients
American Home Visiting Physicians Past Accepting new patients

Locations

2800 N Sheridan Rd
Ste 60
Chicago, IL 60657
Phone (773) 525-8846

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

800 Austin St
Ste 506
Evanston, IL 60202
Phone (708) 328-1112

800 Austin St
Evanston, IL 60202
Phone (847) 316-8700

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

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

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

7380 N Lincoln Ave
Lincolnwood, IL 60712
Phone (847) 568-7400

9977 Woods Dr
Skokie, IL 60077
Phone (847) 663-8540

9977 Woods Dr
Ste 100
Skokie, IL 60077

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Birchwood Plaza Inc.Chicago, IL, CCN 145532 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jan 1, 2020
Jan 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1487640660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 KNOX AVE",
            "address_2": "SUITE 102",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761256",
            "telephone_number": "847-677-1112",
            "fax_number": "847-674-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 KNOX AVE",
            "address_2": "SUITE 102",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761256",
            "telephone_number": "847-677-1112",
            "fax_number": "847-674-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDINGHAUS",
        "first_name": "WOLF",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036053477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.