Individual provider Active NPI

Richard J Wiet, M.D.

  • Otology & Neurotology Physician
  • Hinsdale, IL
National Provider Identifier
1760464911
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
036-047459 Issued in IL
Practice address
11 Salt Creek LN
Suite 101
Hinsdale, IL 60521-2990
Phone
(630) 789-3110
Fax
(630) 789-3137
NPI assigned
Nov 15, 2005
Last updated
Mar 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X 036-047459 IL Primary

Addresses

Primary practice location

11 Salt Creek LN
Suite 101
Hinsdale, IL 60521-2990

Mailing address

11 Salt Creek LN
Suite 101
Hinsdale, IL 60521-2990
Phone (630) 789-3110

Other identifiers 3

IdentifierTypeStateIssuer
403270OtherILMEDICARE GROUP PTAN
36047459MedicaidIL
400280OtherILGROUP MEDICARE PTAN

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Institute of Chicago LLC Otology & Neurotology PastSince Jul 1, 2002 Accepting new patients
Adventist Health Partners, Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1760464911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SALT CREEK LN",
            "address_2": "SUITE 101",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212990",
            "telephone_number": "630-789-3110",
            "fax_number": "630-789-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SALT CREEK LN",
            "address_2": "SUITE 101",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212990",
            "telephone_number": "630-789-3110",
            "fax_number": "630-789-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIET",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "IL",
            "license": "036-047459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "403270",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36047459",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "400280",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.