DR. THEODORE TOERNE MD
NPI 1902814502
Emergency Medicine in Oak Lawn, IL
NPI Status: Active since August 03, 2006
Contact Information
4440 W 95TH ST
DEPARTMENT OF EMERGENCY MEDICINE
OAK LAWN, IL
ZIP 60453
Phone: (708) 684-5354
Fax: (708) 684-1028
- Individual
- Male
- Emergency Medicine
- Accepts Insurance
- PECOS Enrolled
About THEODORE TOERNE
This page provides the complete NPI Profile along with additional information for Theodore Toerne, a provider established in Oak Lawn, Illinois with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1902814502 assigned on August 2006. The practitioner's primary taxonomy code is 207P00000X with license number 360940030 (IL). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1902814502
- Provider Name
- DR. THEODORE TOERNE MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4440 W 95TH ST DEPARTMENT OF EMERGENCY MEDICINE OAK LAWN, IL 60453
- Location Phone
- (708) 684-5354
- Location Fax
- (708) 684-1028
- Mailing Address
- 66 W 15TH ST CHICAGO, IL 60605
- Mailing Phone
- (312) 922-1553
- Mailing Fax
- (708) 684-1028
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-03-2006
- Last Update Date
- 05-02-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 360940030
- License State
- IL
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | 2282-320 (WI) |
| 2 | 207PT0002X | Allopathic & Osteopathic Physicians | Emergency Medicine | 360940030 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Engage by Medica Bronze HSA - EPO
- Engage by Medica Bronze Share - EPO
- Engage by Medica Expanded Bronze Standard - EPO
- Engage by Medica Gold $0 Copay PCP Visits - EPO
- Engage by Medica Gold Share - EPO
- Engage by Medica Gold Standard - EPO
- Engage by Medica Silver $0 Copay PCP Visits - EPO
- Engage by Medica Silver Share - EPO
- Engage by Medica Silver Standard - EPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - HMO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
- Medica Insure Bronze Premier - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 360940030 | MEDICAID (05) | IL |
Medicare Participation & PECOS Enrollment Status
Theodore Toerne is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of moderate severity
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 105 times for 102 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 56 times for 53 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 43 times for 40 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 81 times for 80 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 60453 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $94.06
- Minimum New Patient Price $60.08
- Maximum New Patient Price $183.39
- Average New Patient Copayment $23.51
- Minimum New Patient Copayment $15.02
- Maximum New Patient Copayment $45.84
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $105.7
- Minimum Established Patient Price $18.97
- Maximum Established Patient Price $148.12
- Average Established Patient Copayment $26.42
- Minimum Established Patient Copayment $4.74
- Maximum Established Patient Copayment $37.03
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 0 | 2 | 8 | 1 | 4 | 5 | 0 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 0 | 2 | 16 | 1 | 8 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 0 + 2 + 1 + 6 + 1 + 8 + 5 + 0 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1902814502 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1497741904 | MUHAMMAD HAQUE MD Individual | Physical Medicine & Rehabilitation | 4440 W 95TH ST EMG LAB, ROOM 042 SOUTH OAK LAWN, IL 60453 (708) 684-5428 |
| 1396731329 | RAJEEV NAGPAL MD Individual | Pediatrics (Pediatric Gastroenterology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5650 |
| 1720074685 | STEPHEN SOKALSKI DO Individual | Internal Medicine (Infectious Disease) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5674 |
| 1932195716 | WILLIAM ADAIR MD Individual | Physical Medicine & Rehabilitation | 4440 W 95TH ST EMG LAB, ROOM 042 SOUTH OAK LAWN, IL 60453 (708) 684-5428 |
| 1962483669 | MIDWEST PEDIATRIC CARDIOLOGY, P.C. Organization | Pediatrics (Pediatric Cardiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5580 |
| 1235110958 | MR. EARL PHILIP OW MD Individual | Pediatrics (Pediatric Cardiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5580 |
| 1497736839 | CONSULTANTS IN RADIATION ONCOLOGY S.C. Organization | Radiology (Radiation Oncology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5475 |
| 1497737514 | DR. PRAMILLA SARIN MD Individual | Radiology (Radiation Oncology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 346-3055 |
| 1316929177 | DR. HAM NYUNG LEE MD Individual | Radiology (Radiation Oncology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 346-5475 |
| 1982686655 | DR. JOHN DAVID MORGAN III MD Individual | Radiology (Radiation Oncology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 346-3055 |
| 1477537215 | RICHARD E HELLER III MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 648-5520 |
| 1912981762 | GEORGE S HALLENBECK MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 648-5520 |
| 1376527127 | SAAGARAPPILLAI ASOKAN MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5520 |
| 1376527119 | ALTHURU REDDY MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5520 |
| 1275517013 | GLENN C HENRIKSON DO Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5520 |
| 1174507917 | JOSE RAMILO MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5520 |
| 1407830243 | FREDERICK S FANAPOUR MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 648-5520 |
| 1518941368 | MARK R NITEKMAN MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5520 |
| 1285619627 | UPMA K RAWAL MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 684-5520 |
| 1093790438 | NIHAL GOONERATNE MD Individual | Radiology (Diagnostic Radiology) | 4440 W 95TH ST OAK LAWN, IL 60453 (708) 648-5520 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902814502, enumerated in the NPI registry as an "individual" on August 03, 2006
The provider is located at 4440 W 95th St Department Of Emergency Medicine Oak Lawn, Il 60453 and the phone number is (708) 684-5354
The provider's speciality is Emergency Medicine with taxonomy code 207P00000X
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medica,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $94.06 with an average copayment of $23.51 for new patient appointments. Established patients should expect a typical charge of $105.7 and an average copayment of 26.42. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity, Emergency department visit for problem of moderate severity and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only.
This NPI record was last updated on August 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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