Midwest Endocrine Surgery PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MIDWEST ENDOCRINE SURGERY PC

Practice address

7447 W Talcott Ave Ste 121
Chicago, IL 60631-3712

Phone

(775) 600-9449

NPI assigned

Sep 1, 2023

Organization subpart

No

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

Authorized official

Name

Douglas Wiseman, MDNPI 1003137803

Title

Surgeon-Owner

Phone

(775) 600-9449

Specialties & licenses 1

Addresses

Other names 1

• Midwest Endocrine Surgery, S.C. Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas Wiseman, MD

  • Surgery Physician
  • Chicago, IL
  • NPI 1003137803
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1972389328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WILLIAMS CT",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605144500",
            "telephone_number": "775-600-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE STE 121",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313712",
            "telephone_number": "775-600-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ENDOCRINE SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "WISEMAN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "SURGEON-OWNER",
        "authorized_official_telephone_number": "775-600-9449",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Endocrine Surgery, S.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.