Organization Active NPI

Lawrence D. Wolin, M.D.,S.C.

Doing business as Northwest Ophthalmology

  • Ophthalmology Physician
  • Arlington Heights, IL
National Provider Identifier
1669654513
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036059451 Issued in IL
Legal business name
LAWRENCE D. WOLIN, M.D.,S.C.
Doing business as
Northwest Ophthalmology
Practice address
1602 W Central Rd
Arlington Heights, IL 60005-2407
Phone
(847) 255-3515
Fax
(847) 255-8727
NPI assigned
Dec 3, 2007
Last updated
Feb 14, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
LAWRENCE D. WOLIN, M.D.,S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Authorized official

Name
Dr. Lawrence D Wolin, MDNPI 1982606836
Title
Physician
Phone
(847) 255-3515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 036059451 IL Primary

Addresses

Primary practice location

1602 W Central Rd
Arlington Heights, IL 60005-2407

Mailing address

1602 W Central Rd
Arlington Heights, IL 60005-2407
Phone (847) 255-3515

Other identifiers 3

IdentifierTypeStateIssuer
036059451MedicaidIL
1623380OtherILBCBS
180037165OtherILMEDIARE RAILROAD

Other names 1

  • Northwest Ophthalmology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080602000766 IL Part B Supplier - Clinic/Group Practice 1850461906 Receives reassigned benefits from 3 practitioners
Practice locations: Arlington Heights, IL

National Provider Directory

National Provider Directory
Part of
Lawrence D Wolin MD SC

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1669654513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052407",
            "telephone_number": "847-255-3515",
            "fax_number": "847-255-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052407",
            "telephone_number": "847-255-3515",
            "fax_number": "847-255-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE D. WOLIN, M.D.,S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAWRENCE D. WOLIN, M.D.,S.C.",
        "enumeration_date": "2007-12-03",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "WOLIN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-255-3515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036059451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059451",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1623380",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIARE RAILROAD",
            "identifier": "180037165",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Ophthalmology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.