Individual provider Active NPI

Eisha Wali, M.D.

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1932580529
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036.145330 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637
Phone
(773) 702-1000
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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 036.145330 IL
Hospitalist Physician 208M00000X 036145330 IL
Cardiovascular Disease Physician 207RC0000X 036.145330 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

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
I20180813003160 IL Practitioner - Cardiovascular Disease (Cardiology) 9638481245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1000 Central St
Evanston, IL 60201-1780

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2050 Pfingsten Rd
Suite 330
Glenview, IL 60026-1300
Phone (847) 998-4100

2050 Pfingsten Rd
Suite 360
Glenview, IL 60026-1313
Phone (847) 657-5959

2100 Pfingsten Rd
Glenview, IL 60026-1301

2150 Pfingsten Rd
Glenview, IL 60026-1326

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

777 Park Ave W
Highland Park, IL 60035-2433

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.145330ILMDCardiovascular Disease Physician
036145330ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Jul 1, 2018 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 9, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 1, 2018 Accepting new patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2150 Pfingsten Rd
Ste 1200
Glenview, IL 60026
Phone (847) 657-1819

2150 Pfingsten Rd
Glenview, IL 60026
Phone (847) 486-6550

9650 Gross Point Rd
Ste 4900
Skokie, IL 60076
Phone (847) 663-8050

Organizations & group practices 4

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 5

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1932580529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALI",
        "first_name": "EISHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.145330",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036145330",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.145330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.