Paul K Wiemerslage, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015124 Issued in IL

Practice address

5537 N Broadway St
Chicago, IL 60640-1405

Phone

(773) 989-9400

Fax

(773) 989-9494

NPI assigned

Mar 14, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 18, 2019 through Jul 18, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Meridian Psychiatric Partners, LLC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1982873766
  NPD (past)

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1699040378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5537 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401405",
            "telephone_number": "773-989-9400",
            "fax_number": "773-989-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5537 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401405",
            "telephone_number": "773-989-9400",
            "fax_number": "773-989-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMERSLAGE",
        "first_name": "PAUL",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.015124",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Sabine Wieger, PT
• Colleen Frances Wieland, SLP
• Jozef F Wielgus, PHARMACY TECHNICIAN
• Melanie Victoria Wielicka, MD
• Madeline Mae Wiemers, RDN
• Gregory Alan Wiener, MD, FACS
• Joanna Marie Wiener
• Zachary Wiener
• Robert Ignace Wier, ROBERT WIER
• Robert Steven Wier, ROBERT S. WIER DDS

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.