Individual provider Active NPI

Elliot Weisenberg, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1770575136
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036084232 Issued in IL
Practice address
840 S Wood St
Chicago, IL 60612-4325
Phone
(312) 996-7312
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036084232 IL Primary

Addresses

Primary practice location

840 S Wood St
Chicago, IL 60612-4325

Mailing address

840 S Wood St
Chicago, IL 60612-4325
Phone (312) 996-7312

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
I20100526000448 IL Practitioner - Pathology 5698804854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

840 S Wood St 130 CSN
Uic Pathology
Chicago, IL 60612-4325
Phone (312) 996-7313

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036084232ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Diagnostic Pathology SC Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2002 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Nov 1, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2024 Accepting new patients

Locations

1819 W Polk St
Chicago, IL 60612
Phone (312) 996-6604

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

840 S Wood St
#130
Chicago, IL 60612
Phone (312) 996-3879

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

836 W Wellington Ave
Chicago, IL 60657
Phone (773) 296-7054

840 S Wood St
Chicago, IL 60612
Phone (312) 996-6711

520 E 22nd St
Lombard, IL 60148
Phone (630) 874-2542

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

Interoperability endpoints

  • Direct secure messaging: eweisenberg179393@uihealth.direct-ci.com
  • Direct secure messaging: eweisenberg282680@direct.myadvocateaurora.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1770575136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISENBERG",
        "first_name": "ELLIOT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036084232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.