Wayne M Detmer, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-099461 Issued in IL

Practice address

3860 W Ogden Ave
Chicago, IL 60623-2460

Phone

(872) 588-3000

Fax

(872) 588-3021

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

University of Chicago, Pritzker School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lawndale Christian Health CenterGroup PAC ID 2264336346, 124 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wdetmer690730@direct.ochin.org

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Saint Anthony Hospital

  • General Acute Care Hospital
  • Cicero, IL
  • NPI 1184490062

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1194723999

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • Psychiatric Hospital Unit
  • Chicago, IL
  • NPI 1518170877

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1538655949

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • Children's Hospital
  • Chicago, IL
  • NPI 1619456423

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1710877386

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • Community/Retail Pharmacy
  • Chicago, IL
  • NPI 1790490563

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1881363224

  Corporate Director

  CMS ownership
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912397480

  Corporate Director

  CMS ownership

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.

• Lawndale Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1245289214
  Medicare reassignment Care Compare group NPD
• Lawndale Christian Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1588537641
  NPD
• Lawndale Christian Health Center

  • Community/Retail Pharmacy
  • Chicago, IL
  • NPI 1679680235
  NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1972558880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000",
            "fax_number": "872-588-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000",
            "fax_number": "872-588-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETMER",
        "first_name": "WAYNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-099461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hali Deters, DC
• Joseph Sieve Deters, M.D.
• Tara Jane Dethmers, APRN, CNM
• Luke Detloff
• Gina L Detmer, M.D.
• Joyce Detrich, LMT
• Deborah Lynn Dettman, LCSW, LICSW, SUDP
• Jamine L Dettmering, BCBA
• Julia Debra Dettner
• Linda Deubel, LCPC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.