Active NPI
Stephen A Weinberg, DPM
- Podiatrist
- Des Plaines, IL
National Provider Identifier
1548268121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 016-002671
- Practice address
- 1455 E Golf Rd
Suite 110
Des Plaines, IL 60016-1250 - Phone
- (847) 390-7666
- Fax
- (847) 390-9345
- NPI assigned
- Jul 8, 2005
- Last updated
- Jul 24, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 016-002671 | IL | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 016002671 | IL |
Addresses
Primary practice location
1455 E Golf Rd
Suite 110
Des Plaines, IL 60016-1250
Mailing address
1455 E Golf Rd
Suite 110
Des Plaines, IL 60016-1250
Phone (847) 390-7666
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016002671 | Medicaid | IL | |
| 60000380 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016-002671 | IL | MD | Podiatrist |
| 016002671 | IL | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1548268121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1455 E GOLF RD",
"address_2": "SUITE 110",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600161250",
"telephone_number": "847-390-7666",
"fax_number": "847-390-9345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 E GOLF RD",
"address_2": "SUITE 110",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600161250",
"telephone_number": "847-390-7666",
"fax_number": "847-390-9345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINBERG",
"first_name": "STEPHEN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "016-002671",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "016002671",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016002671",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "60000380",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.