Elizabeth Marie Wollensak, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.137629 Issued in IL

Practice address

6853 North Ave
Oak Park, IL 60302-1023

Phone

(708) 383-3010

Fax

(708) 383-6475

NPI assigned

Mar 24, 2012

Last updated

Apr 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 23, 2016 through Feb 23, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Pediatrics Unlimited PLLC

  • Specialist
  • Oak Park, IL
  • NPI 1699005272
  NPD (past)
• Rosa Hae S. Choi M.D., S.C.

  • Specialist
  • Oak Park, IL
  • NPI 1164608881
  NPD (past)

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

{
    "created_epoch": "1332547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1508132507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6853 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021023",
            "telephone_number": "708-383-3010",
            "fax_number": "708-383-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6853 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021023",
            "telephone_number": "708-383-3010",
            "fax_number": "708-383-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLENSAK",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-24",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.137629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen Withers, LCSW, LISW
• Heather Witthoff, MSW, LCSW
• Andrew Wojda, LCSW
• Wolff Clinical Group PLLC
• Kara E Wolff, PHD
• Seth Drummond Wollwage, L.C.S.W.
• Brad Scott Wolter, PT
• Michele M Wolter, OTRL
• Ka Ngan Wong, OTR/L
• Michelle Gloria Wong

• Pediatrics Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.