Individual provider Active NPI

Gregory Alan Wiener, MD, FACS

  • Plastic Surgery Physician
  • Chicago, IL
National Provider Identifier
1609969765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Practice address
7447 W Talcott Ave
Ste 451
Chicago, IL 60631-3745
Phone
(773) 763-3990
Fax
(773) 763-6346
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X IL Primary

Addresses

Primary practice location

7447 W Talcott Ave
Ste 451
Chicago, IL 60631-3745

Mailing address

7447 W Talcott Ave
Ste 451
Chicago, IL 60631-3745
Phone (773) 763-3990

Other identifiers 1

IdentifierTypeStateIssuer
1623188OtherILBCBS

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
I20110209000789 IL Practitioner - Plastic and Reconstructive Surgery 8628258597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5440 N Cumberland Ave
Suite 105
Chicago, IL 60656-4700
Phone (773) 763-3990

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036089877ILMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory a Wiener MD SC Plastic Surgery CurrentSince Oct 1, 1999 Accepting new patients

Locations

5440 N Cumberland Ave
Ste 105
Chicago, IL 60656
Phone (773) 763-3990

7447 W Talcott Ave
Ste 451
Chicago, IL 60631
Phone (773) 763-3990

Organizations & group practices 1

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609969765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "STE 451",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-763-3990",
            "fax_number": "773-763-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "STE 451",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-763-3990",
            "fax_number": "773-763-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "credential": "MD, FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1623188",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.