Individual provider Active NPI

Irving Waxman, MD

  • Gastroenterology Physician
  • Burr Ridge, IL
National Provider Identifier
1487717906
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Practice address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone
(773) 834-4064
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X IL Primary

Addresses

Primary practice location

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686

Mailing address

5841 S Maryland Ave # Mc1099
Chicago, IL 60637-1447

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
I20060406000380 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 8628087475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 207
Chicago, IL 60612-3988
Phone (312) 942-5861

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy19
Upper gastrointestinal (GI) endoscopy for acid reflux154

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center Gastroenterology CurrentSince Oct 1, 2021 Accepting new patients
The University of Chicago Medical Center CurrentSince Jun 30, 2002 Accepting new patients
Rush University Medical Group CurrentSince Oct 1, 2021 Accepting new patients
The University of Chicago Medical Center CurrentSince Jun 30, 2002 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 207
Chicago, IL 60612

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

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

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: iwaxmanmd23555@uchospital.direct-ci.com
  • Direct secure messaging: iwaxman185698@direct.rush.rush-health.com

Organizations & group practices 4

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.

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487717906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC1099",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-834-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "IRVING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.