Individual provider Active NPI

Nicholas Taylor Woolf, MD, MA

  • Pediatrics Physician
  • Harvey, IL
National Provider Identifier
1528595659
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036151851 Issued in IL
Practice address
31 W 155TH St
Harvey, IL 60426-3556
Phone
(708) 596-5177
Fax
(708) 596-5518
NPI assigned
May 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036151851 IL Primary

Addresses

Primary practice location

31 W 155TH St
Harvey, IL 60426-3556

Mailing address

31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177

Other practice location 1

5841 S Maryland Ave # Mc8016
Chicago, IL 60637-1447
Phone (773) 702-6435

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
I20200901001556 IL Practitioner - Pediatric Medicine 0749559540 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036151851ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Friend Family Health Center Inc CurrentSince Dec 13, 2023 Accepting new patients
Family Christian Health Center CurrentSince Jul 12, 2021 Accepting new patients
Family Christian Health Center CurrentSince Jul 12, 2021 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 17, 2020 Accepting new patients
Friend Family Health Center, Inc CurrentSince Dec 13, 2023 Accepting new patients
Friend Family Health Center Inc Current Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 17, 2020 Accepting new patients
Ucm Medical Group Sub, LLC Past Accepting new patients

Locations

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

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

5635 S Pulaski Rd
Chicago, IL 60629
Phone (773) 767-4359

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

6250 S Cottage Grove Ave
Chicago, IL 60637
Phone (312) 682-6110

31 W 155th St
Harvey, IL 60426
Phone (708) 596-5177

Interoperability endpoints

  • Direct secure messaging: nicholas.woolf.1@11074.direct.athenahealth.com
  • Direct secure messaging: nwoolfmd152105@uchospital.direct-ci.com

Organizations & group practices 9

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": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1528595659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave # Mc8016",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-702-6435",
            "fax_number": "773-834-0748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOLF",
        "first_name": "NICHOLAS",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "MD, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-19",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036151851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.