Organization Active NPI

Vadim Edelstein MD LTD

Doing business as Oakton Park Medical Center

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1912951617
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
VADIM EDELSTEIN MD LTD
Doing business as
Oakton Park Medical Center
Practice address
4555 Oakton St
Skokie, IL 60076-3178
Phone
(847) 982-9988
Fax
(847) 982-9789
NPI assigned
May 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Vadim EdelsteinNPI 1760431076
Title
MD
Phone
(847) 982-9988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Primary

Addresses

Primary practice location

4555 Oakton St
Skokie, IL 60076-3178

Mailing address

4555 Oakton St
Skokie, IL 60076-3178
Phone (847) 982-9988

Other names 1

  • Oakton Park Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040113000228 IL Part B Supplier - Clinic/Group Practice 5092615278 Receives reassigned benefits from 4 practitioners
Practice locations: Chicago, IL; Skokie, IL; Northbrook, IL; Niles, IL; Morton Grove, IL; Evanston, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0936035Vadim Edelstein MD LTD4555 Oakton Street, Skokie, IL 60076Certificate of waiverNov 13, 2027

National Provider Directory

National Provider Directory

Locations

2965 W Peterson Ave
Chicago, IL 60659
Phone (773) 275-9700

3330 Dundee Rd
Ste C2
Northbrook, IL 60062
Phone (847) 480-7877

610 S Maple Ave
Ste 4000
Oak Park, IL 60304
Phone (706) 660-6301

4555 Oakton St
#1
Skokie, IL 60076
Phone (847) 982-9988

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1912951617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763178",
            "telephone_number": "847-982-9988",
            "fax_number": "847-982-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763178",
            "telephone_number": "847-982-9988",
            "fax_number": "847-982-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VADIM EDELSTEIN MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EDELSTEIN",
        "authorized_official_first_name": "VADIM",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "847-982-9988",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakton Park Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.