Individual provider Active NPI

Samuel E Weinberg

  • Immunopathology Physician
  • Chicago, IL
National Provider Identifier
1538515473
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Immunopathology PhysicianTaxonomy code 207ZI0100X
License
036160912 Issued in IL
Practice address
710 N Fairbanks CT Ste 2-458
Chicago, IL 60611-3013
Phone
(312) 926-3211
Fax
(312) 503-8259
NPI assigned
May 10, 2016
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Immunopathology Physician 207ZI0100X 036160912 IL Primary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 125075240 IL

Addresses

Primary practice location

710 N Fairbanks CT Ste 2-458
Chicago, IL 60611-3013

Mailing address

710 N Fairbanks CT Ste 2-458
Chicago, IL 60611-3013
Phone (312) 926-3211

Other practice location 1

240 E Huron St
Suite 1-200
Chicago, IL 60611-2909
Phone (312) 503-7975

Other practice location 2

251 E Huron St
Chicago, IL 60611-3055
Phone (312) 926-2000

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
I20230730000016 IL Practitioner - Pathology 9133580731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Northwestern University Feinberg Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125075240ILMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2023 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Chicago, IL 60611

251 E Huron St
Ste 7132G
Chicago, IL 60611
Phone (312) 503-8144

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 2

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 7

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1538515473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N FAIRBANKS CT STE 2-458",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113013",
            "telephone_number": "312-926-3211",
            "fax_number": "312-503-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N FAIRBANKS CT STE 2-458",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113013",
            "telephone_number": "312-926-3211",
            "fax_number": "312-503-8259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 E Huron St",
            "address_2": "Suite 1-200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112909",
            "country_code": "US",
            "telephone_number": "312-503-7975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606113055",
            "country_code": "US",
            "telephone_number": "312-926-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEINBERG",
        "first_name": "SAMUEL",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZI0100X",
            "taxonomy_group": "",
            "desc": "Pathology, Immunopathology",
            "state": "IL",
            "license": "036160912",
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "IL",
            "license": "125075240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.