NPIMap

Individual provider Active NPI

William Fred Polito, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Elgin, IL
National Provider Identifier
1992744288
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
036116188 Issued in IL
Practice address
1435 N Randall Rd Ste 210
Elgin, IL 60123-2303
Phone
(847) 695-1620
Fax
(888) 990-2186
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036116188 IL Primary

Addresses

Primary practice location

1435 N Randall Rd Ste 210
Elgin, IL 60123-2303

Mailing address

9500 Bormet Dr Ste 204
Mokena, IL 60448-8399
Phone (708) 346-4044

Other identifiers 1

IdentifierTypeStateIssuer
036116188MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wpolito236521@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000132 IL Practitioner - Cardiac SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 6608871546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
Medical College of Georgia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiothoracic and Vascular Surgical Associates S CGroup PAC ID 7214916402, 48 clinicians

Practice addresses (Care Compare)

4400 W 95TH St
Suite 308
Oak Lawn, IL 60453-2660
Phone (708) 346-4040

Hospital & facility affiliations

  • Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)25

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: wpolito236521@direct.myadvocateaurora.org
  • Direct secure messaging: wpolito151681@direct.rush.rush-health.com

Organizations & group practices 1

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 9

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1992744288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 BORMET DR STE 204",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488399",
            "telephone_number": "708-346-4044",
            "fax_number": "708-346-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 N RANDALL RD STE 210",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601232303",
            "telephone_number": "847-695-1620",
            "fax_number": "888-990-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "WILLIAM",
        "middle_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036116188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036116188",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wpolito236521@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1435 N Randall Rd Ste 210",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601232303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.