Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Waveland Medical Center SC

Organization Family Medicine Physician · NPI 1407996622

Waveland Medical Center SC is a Family Medicine Physician in Chicago, Illinois. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
3

Practice location Address checks out

840 W Irving Park Rd #201
Chicago, IL 60613-3011
Phone: (773) 935-4470
Fax: (773) 935-5598
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Podiatrist Taxonomy 213E00000X

Record details

NPI number1407996622
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daniel Shin — Physician · (773) 935-4470
NPI enumeratedFebruary 7, 2007
Last updated in NPPESOctober 5, 2009
Mailing address840 W Irving Park Rd, 201, Chicago, IL 60613-3011

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