Individual provider Active NPI

Heidi B Renner, MD

  • Internal Medicine Physician
  • Maywood, IL
National Provider Identifier
1972706299
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036115745 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036115745 IL
Internal Medicine Physician 207R00000X 036115745 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Other practice location 1

1001 Commerce Dr Ste 500
Oak Brook, IL 60523-8865
Phone (331) 732-4410

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
I20070910000362 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8224121140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1001 Commerce Dr
Oak Brook, IL 60523-8865

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036115745ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2024 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2160 S 1st Ave
Bldg 105
Maywood, IL 60153
Phone (708) 216-1676

1001 Commerce Dr
Ste 500
Oak Brook, IL 60523
Phone (331) 732-4490

Interoperability endpoints

  • Direct secure messaging: hrenner27594@direct.luhs.org

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 8

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1972706299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Commerce Dr Ste 500",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605238865",
            "country_code": "US",
            "telephone_number": "331-732-4410",
            "fax_number": "331-732-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENNER",
        "first_name": "HEIDI",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036115745",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036115745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.