Individual provider Active NPI

Wren Willow Logan, M.D.

  • Neurology Physician
  • Chicago, IL
National Provider Identifier
1982139705
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036.160349 Issued in IL
Practice address
3948 N Sheridan Rd
Chicago, IL 60613-2935
Phone
(773) 388-1600
Fax
(773) 388-8936
NPI assigned
Apr 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X 036.160349 IL Primary

Addresses

Primary practice location

3948 N Sheridan Rd
Chicago, IL 60613-2935

Mailing address

3948 N Sheridan Rd
Chicago, IL 60613-2935
Phone (773) 388-1600

Other practice location 1

Uw Hospitals and Clinics
600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

Other identifiers 1

IdentifierTypeStateIssuer
036.160349MedicaidIL

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
I20220719001045 IL Practitioner - Psychiatry 2365712379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard Brown Health CenterGroup PAC ID 1052203155, 52 clinicians

Practice addresses (Care Compare)

1525 E 55TH St
Suite 201
Chicago, IL 60615-5582
Phone (773) 388-1600

4009 N Broadway St
Chicago, IL 60613-2110
Phone (773) 388-1600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.160349ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center CurrentSince May 11, 2022 Accepting new patients
Howard Brown Health Center CurrentSince Apr 13, 2025 Accepting new patients
Howard Brown Health Center CurrentSince May 11, 2022 Accepting new patients
Howard Brown Health Center Current Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

3948 N Sheridan Rd
Chicago, IL 60613
Phone (773) 502-8252

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

Interoperability endpoints

  • Direct secure messaging: wlogan590206@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1493510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1982139705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132935",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132935",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Uw Hospitals and Clinics",
            "address_2": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "WREN",
        "middle_name": "WILLOW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-30",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.160349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036.160349",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.