Brian Edmund Walczak, DO

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036163012 Issued in IL

Practice address

2111 Ogden Ave
Aurora, IL 60504-7597

Phone

(630) 978-3800

NPI assigned

Jun 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

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

Specialty

Orthopedic Surgery

Education

Chicago College of Osteopathy, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Rush-Copley Orthopedics, LLCGroup PAC ID 9133417454, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment Care Compare group NPD
• Rush-Copley Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Aurora, IL
  • NPI 1538616693
  Medicare reassignment Care Compare group NPD
• Rush Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1467312850
  Medicare reassignment
• Rush University Medical Center

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1801375696
  NPD

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

• Copley Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Aurora, IL
  • NPI 1295882561
  Care Compare affiliation

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1538366158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 OGDEN AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 OGDEN AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047597",
            "telephone_number": "630-978-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCZAK",
        "first_name": "BRIAN",
        "middle_name": "EDMUND",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101017411",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "106196",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036163012",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WI",
            "license": "518269",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036163012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Habiba Waheed, M.D.
• Benjamin Roy Wahlund
• Alina Nichole Wajda
• Ty Wakefield, LCSW
• Wal-Mart Stores Inc
• Laura A. Waldoch, N.P.-C
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co

• Orthopaedic Surgery Physician in Aurora, IL
• Providers in Aurora, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.