Individual provider Active NPI

Lu Wang

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1912225970
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
125059720 Issued in IL
Practice address
201 E Huron St. Northwestern Memorial Hospital
7-132A
Chicago, IL 60611
Phone
(312) 503-8144
NPI assigned
May 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 125059720 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X 11015359A IN
Student in an Organized Health Care Education/Training Program 390200000X 57.016540 OH
Student in an Organized Health Care Education/Training Program 390200000X 125059720 IL

Addresses

Primary practice location

201 E Huron St. Northwestern Memorial Hospital
7-132A
Chicago, IL 60611

Mailing address

278 N Oaklawn Ave Unit 3
Elmhurst, IL 60126-2523
Phone (630) 333-9006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150617000600 IL Practitioner - Pathology 9830400894 Reassigns benefits to 1 organization
I20160629001545 WI Practitioner - Pathology 9830400894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hart Road Pathology, SCGroup PAC ID 7113986100, 3 clinicians

Practice addresses (Care Compare)

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5131

Hospital & facility affiliations

  • Beloit Health System Hospital, Beloit, WI, CCN 520100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125059720ILMDAnatomic Pathology & Clinical Pathology Physician
11015359AINMDStudent in an Organized Health Care Education/Training Program
57.016540OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2015 Accepting new patients
Hart Road Pathology SC CurrentSince Jun 30, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2015 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

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": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1912225970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 N OAKLAWN AVE UNIT 3",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262523",
            "telephone_number": "630-333-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HURON ST. NORTHWESTERN MEMORIAL HOSPITAL",
            "address_2": "7-132A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-503-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LU",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-13",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125059720",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11015359A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.016540",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125059720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.