Active NPI
Thomas A Widell, M.D.
- Emergency Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036084421
- Practice address
- 1501 S California Ave
Chicago, IL 60608 - Phone
- (773) 257-6843
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036084421 | IL | Primary |
Addresses
Primary practice location
1501 S California Ave
Chicago, IL 60608
Mailing address
3537 Paysphere Cir
Chicago, IL 60674-0035
Phone (708) 786-2900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-084421-2 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 542-2000
Hospital & facility affiliations
- Mt Sinai Hospital Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.41 of 100
- Quality
- 86.81
- Improvement activities
- 40
- Cost
- 77.34
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cepamerica Illinois LLP | Emergency Medicine | Current | Accepting new patients |
| Cepamerica Illinois LLP | Emergency Medicine | Current | Accepting new patients |
| Cep America - Illinois, LLP | Emergency Medicine | Current | Accepting new patients |
| Emergency Care Physician Services | Emergency Medicine | Past | Accepting new patients |
| Unimed, LTD | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000
1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701
1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Elgin, IL
- NPI 1912283110
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1295288413
-
- Emergency Medicine Physician
- Springfield, IL
- NPI 1871360297
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1568493294
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1205849718
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1871581314
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534809600000",
"number": "1932109188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3537 PAYSPHERE CIR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606740035",
"telephone_number": "708-786-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60608",
"telephone_number": "773-257-6843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDELL",
"first_name": "THOMAS",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2018-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036084421",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-084421-2",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.