Individual provider Active NPI

Nathan Everett Derhammer, M.D.

  • Hospitalist Physician
  • Maywood, IL
National Provider Identifier
1851510770
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036115662 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-5368
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036115662 IL
Pediatrics Physician 208000000X 036115662 IL
Hospitalist Physician 208M00000X 036115662 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

444 Washington Blvd Apt 204
Unit 204
Oak Park, IL 60302-4060
Phone (708) 386-1928

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nderhammer27513@direct.luhs.org Other

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
I20080723000873 IL Practitioner - HospitalistPractitioner - Pediatric Medicine 3678646627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Pediatric Medicine
Education
Wayne State University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036115662ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jul 1, 2008 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Jul 1, 2008 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

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 2

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1851510770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 WASHINGTON BLVD APT 204",
            "address_2": "UNIT 204",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024060",
            "telephone_number": "708-386-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERHAMMER",
        "first_name": "NATHAN",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036115662",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036115662",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036115662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nderhammer27513@direct.luhs.org",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.