Individual provider Active NPI

William Carl Harenburg Jr., M.D.

  • Pediatrics Physician
  • Wheaton, IL
National Provider Identifier
1891968954
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.119728 Issued in IL
Practice address
2001 N Gary Ave Ste 100
Wheaton, IL 60187-3055
Phone
(630) 614-4100
Fax
(630) 614-4148
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.119728 IL Primary

Addresses

Primary practice location

2001 N Gary Ave Ste 100
Wheaton, IL 60187-3055

Mailing address

2001 N Gary Ave Ste 100
Wheaton, IL 60187-3055
Phone (630) 614-4100

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
I20190828001983 IL Practitioner - Pediatric Medicine 7810225836 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.119728ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jul 15, 2019 Accepting new patients
Central Dupage Physician Group Pediatrics CurrentSince Jul 15, 2019 Accepting new patients
Wheaton Pediatrics, LTD. Pediatrics Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

2001 N Gary Ave
Wheaton, IL 60187
Phone (630) 614-4100

2001 N Gary Ave
Ste 110
Wheaton, IL 60187
Phone (630) 614-4100

2001 N Gary Ave
Ste 100
Wheaton, IL 60187
Phone (630) 614-4100

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1891968954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GARY AVE STE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873055",
            "telephone_number": "630-614-4100",
            "fax_number": "630-614-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N GARY AVE STE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873055",
            "telephone_number": "630-614-4100",
            "fax_number": "630-614-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARENBURG",
        "first_name": "WILLIAM",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.119728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.