Gary Wainer, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036060677 Issued in IL

Practice address

6840 Windsor Ave
Berwyn, IL 60402-3441

Phone

(708) 484-0042

Fax

(708) 749-5489

NPI assigned

May 31, 2005

Last updated

Dec 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1750384186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232074",
            "telephone_number": "630-933-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 WINDSOR AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023441",
            "telephone_number": "708-484-0042",
            "fax_number": "708-749-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAINER",
        "first_name": "GARY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036060677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036060677",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Anne Vizgirda, D.D.S.
• Samantha Volk
• Slobodan D Vucicevic, M.D.
• Alison Rose Wagner, BS
• Bradford S. Wainer, D.O.
• Walgreen Co (Walgreens #05076)
• Walgreen Co
• Walgreen Co (Walgreens #11154)
• Walgreen Co. (Walgreens #11154)
• Aijaz Walji, MD

• Family Medicine Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.